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HEDIS Coordinator

HEDIS, a tool used by more than 90 percent of America’s health plans, measures performance on important ranges of care and service. HEDIS coordinators perform different tasks to ensure HEDIS data and reports are accurate, including investigation, auditing, and improvement opportunities.

Job Duties and Responsibilities

  • Coordinate, complete, and update management on all HEDIS processes and results
  • Organize and maintain a plan of action to improve HEDIS scores
  • Request and evaluate reports for member compliance and improvement opportunities for each HEDIS measure
  • Work with providers and internal departments on rate investigation and validation activities, which includes maintaining all evidence, documentation, and changes
  • Oversee the HEDIS project for quality and timeliness regarding nurse assignments, vendor oversight, and timeline adherence
  • Ensure compliance by conducting quality audits and maintaining all data and process controls

Education and Qualifications

  • Bachelor’s degree in related field or equivalent experience
  • 3+ years of quality improvement or healthcare related experience
  • HEDIS requirements preferred
  • Must be organized with the ability to keep accurate notes and records
  • Excellent verbal/written communication skills
  • Proficient in Microsoft Word, Excel, and Outlook
  • Should possess leadership capabilities

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