HEDIS Project Coordinator

Employment Type

: Full-Time


: Miscellaneous

Job Description

Requisition 393-1

Summary: Support Molina Healthcare of California in their annual HEDIS and on-going intervention efforts. Responsible for the coordination of the medical records identification and collection activities, quarterly Missed Services Report Project, various intervention projects and some data extraction. Essential Functions: ? Coordinates the preparation of the annual HEDIS medical record review project which includes Chase MOCK refinement, test run and evaluation of results with manager. ? Generates Missed Services Report production and distribution together with other staff. ? Prepares Annual HEDIS Medical Record abstraction and data entry training manual. ? Assists in collecting and data entering Supplemental Data to help with HEDIS rates. ? Assists in the Medical Record collection process including making phone calls to providers if assigned by manager. ? Prepares the Medical Record Review vendor(s) payroll paperwork. ? Downloads the files from Right Fax when needed. ? Participates in meetings with vendors for Medical Record Collection process and problem solves for the items in issue logs. ? Assists manager in on-going provider and member interventions and incentive efforts as needed. ? Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS, state audits. Knowledge/Skills/Abilities: ? Require familiarity and competence in MS ACCESS, Excel, Word, and Power Point. ? Require competency in extracting files from MS ACCESS databases and text files. ? Ability to import and export files to various applications such as MS Excel and Access. ? Able to do mail merge and printing. ? Excellent verbal and written communication skills. ? Ability to abide by Molina?s policies. ? Ability to maintain attendance to support required quality and quantity of work. ? Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). ? Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers. ? A team player. ? Require flexibility in taking job assignments including ad hoc projects and willingness to cooperate in various projects. Required Education: AA or AS degree in Computer Science or healthcare related fields or equivalent working experience in accomplishing the tasks listed above Required Experience: ? Data extraction by using queries and displays sound logic to determine how and what to extract. ? 0-2+ years Healthcare Industry experience.

Comments for Suppliers:Additional requirements include the following: experience downloading and copying medical records, excellent communications skills, and ability to work independently and professionally. Must be able to travel within Wisconsin.

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