Job Description

The HEDIS Coordinator perform the functions related to the outreach, collection and accurate data entering of medical records and service data, according to HEDIS/ACO Technical Specifications. The Coordinator has excellent reading comprehension skills in order to analyze and process the information collected and distributed. The Coordinator is also detailed in obtaining and reviewing the applicable medical records and clinical criteria. The Coordinator should behave in a professional manner when interfacing with Medical Directors, Physicians (including office staff) and all internal and external customers.

Essential Duties and Responsibilities include the following:

• Thoroughly, accurately and timely collect and data enter clinical information from medical records into a database in accordance with HEDIS technical specifications and ACO specifications (i.e., childhood immunizations, diabetic laboratory data, asthma medication, CAD cholesterol screening).
• Interface with physicians, vendors, members, and internal staff telephonically or in person to obtain data.
• Provide education in regards to collecting data for the STAR/P4P/ACO measures to internal and external staff, as needed.
• Remain updated on NCQA HEDIS Technical Specifications and ACO specification as it applies to STAR/P4P/ACO quality programs.
• Interface with data support and IT to collect data and maintain the database.
• Filing, faxing, copying and scanning of files.
• Able to maintain the quality standards of data entry with less than 5% data entry errors; therefore, 95% or better accuracy in data inputting.
• Strive to meet personal, departmental and organizational goals and targets.
• Ability to manage a heavy workload with frequent interruptions and changing priorities in a fast paced environment.
• Completes assignments within specified time lines.
• Able to work well in a team environment on special projects.
• Skill in working independently, but with supervision.
• Prepares and maintains records and files that are organized, thorough and readily accessible.
• Attend regular team meetings and report findings of data collection and projects.
• When identifies a problem, informs supervisor in a timely manner so the problem can be corrected.
• Transmits ideas and information in a clear and concise manner.
• Other duties as assigned by management.

The pay range for this position at commencement of employment is expected to be between $21 - $23 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full Time Position Benefits:

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness:

• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Vision insurance
• Zero co-payments for employed physician office visits
• Flexible Spending Account (FSA)
• Employer-Paid Life Insurance
• Employee Assistance Program (EAP)
• Behavioral Health Services

Savings and Retirement:

• 401k Retirement Savings Plan
• Income Protection Insurance

Other Benefits:

• Vacation Time
• Company celebrations
• Employee Assistance Program
• Employee Referral Bonus
• Tuition Reimbursement
• License Renewal CEU Cost Reimbursement Program
• Business-casual working environment
• Sick days
• Paid holidays
• Mileage

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

Qualifications

Education and/or Experience:

• High School diploma.
• One year experience in clinical setting preferred.
• Familiarity with managed care, commercial and point of service, medical care preferred.
• HEDIS experience preferred.
• Computer literate with knowledge and experience with specific software such as Word, Excel, Access.