MyCare Medical Group Hiring for HEDIS Supervisor Full Time

The Hedis supervisor is responsible for coordinating and implementing the STAR’s data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5 STAR rating. This role assists with data analysis and report preparation for all required data submissions. The Hedis supervisor provides direction and support to the Hedis coordinator in their market in the implementation of strategies for closing care gaps. This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the Hedis/Quality programs.

Primary Responsibilities:

• Provides leadership and support in establishing the Quality Performance Initiatives at the market level
• Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data
• Participate in NCQA HEDIS or Health Plan audits
• Work with external vendors on data transmission issues
• Analyze data for possible data integrity and data deficits

· Monitors individual and team results to ensure work is completed in a timely manner, in accordance with department standards and procedures, and is in compliance with medical policy and medical necessity guidelines.

• Assigns and prioritizes work, sets goals, and coordinates daily activities of the team
• Attend and participate in all payor quality meetings.
• Performs all other related duties as assigned

JOB REQUIREMENTS

Education and/or Experience

• 5+ years of healthcare experience to include experience in a managed care setting
• HEDIS/STAR experience
• Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
• High School Diploma or GED is required

Required Knowledge, Skills and Abilities

• Critical Thinking / Problem solving

· Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines.

· Ability to communicate effectively, verbally and in writing.

• Excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Ability to be flexible in a continuously changing environment
• Ability to use Microsoft Office, with a focus on Excel (or Libre Calc)
• Ability to collect and accurately relay pertinent information
• Ability to navigate computers, internet programs, and EMR systems
• Accurate, efficient data entry
• Ability to read/understand medical terminology
• Ability to read, understand, and analyze medical records
• Ability to read and understand technical specifications on all quality initiatives
• Ability to multitask and prioritize assignments based on urgency
• Ability to work independently with little to no need for assistance

Duties and Responsibilities include, but are not limited to:

• Assists with all quality measures initiatives, working with clinical offices in capturing the data to support the variables.
• Works all gap reports for 5 STAR and ACO quality measures projects as they become relevant and assists with all quality initiatives as assigned.
• Assists with patient events as needed.
• Accurately enters all identified and validated measures into the practice’s software program(s).
• Timely and accurately reports issues to management, as necessary.
• Meets daily and overall productivity and compliance expectations.
• Other duties as assigned.

· Education and Experience:

· Diploma or GED.

· One to two years’ previous healthcare experience preferred, but not required. This includes, but is not limited to, medical office, medical records, or healthcare quality.

· Knowledge of Microsoft Office programs is required. Must be able to demonstrate abilities in data entry, Excel, and Word via testing at interview.

· Language Ability:

· Ability to read and comprehend medical terminology, instructions, technical specifications, manuals, correspondence, and memos.

· Ability to write simple correspondence.

· Computer Skills:

· To perform this job successfully, an individual must have knowledge of Microsoft Office programs and have an ability to navigate computers, internet programs, and EMR systems.

Schedule:

• Monday thru Friday

Benefits Offered:

· Paid time off

· Health Insurance

· Dental insurance

· Vision insurance

Drug test, background check, is required for this position.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Land O Lakes, FL 34638: Reliably commute or planning to relocate before starting work (Required)

Experience:

• HEDIS: 2 years (Required)
• healthcare (in a manage care setting): 5 years (Required)

License/Certification:

• Epic Certification (Preferred)

Work Location: One location