HEDIS Coordinator
Centene Corporation - Columbia, SC

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Position Purpose:
Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the service and clinical areas.

Knowledge/Experience:
Bachelor’s degree in related field or equivalent experience. 3+ years of quality improvement or healthcare related experience. Working knowledge of the National Committee on Quality Assurance (NCQA) HEDIS requirements preferred.

Position Responsibilities:
  • Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results
  • Establish and maintain an action plan to improve HEDIS scores
  • Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
  • Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidences, documentations, and changes
  • Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality
  • Conduct quality audit and maintain all data and process controls to ensure compliance

Centene Corporation - 20 months ago - save job - block
About this company
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Centene is sensitive to the needs of individuals and families enrolled in government-assisted health programs. The company provides managed...