HEDIS Coordinator

Title: HEDIS Coordinator
Duration: 06 Months (Potential to extend) 
Location: Louisville, KY 40223
Shift: 7 am-7 pm (8 hours within a time zone that with some flexibility)
 

Responsibilities: Retrieval/Pursuit contractors will be working on the collection of charts, contact/coordination with providers either through phone/fax/email or EMR avenues.  May use various portals to obtain medical records.  Will be responsible for upload, combining, reviewing (quality checking) and ensuring that all documentation is received and noted in the system. May be asked to go onsite to retrieve records (very minimally)  They will be coordinated from a FTE to ensure and the FTE will review quality and set up productivity standards.   Contractors will also be expected to be inter-reliability reviewed (IRR) and complete testing for measures that they are pulling. Abstracting/Research/Overread Contractors will be reviewing any medical records at different intervals in the project.  In supplemental will be abstracting the chart for medical record compliance.  Productivity and quality standards will be reviewed continuously.  Expectation will be to complete testing for measures at 100% for at least 4 measures.  Abstraction will be expected to maintain productivity at 35 charts per day (min) and 95% overall quality score.   Research will be reviewing all charts that continue to be non-compliant for any measure that they are approved for.  Will be looking various claims systems and other items to close gaps.   Overread will be responsible for non-compliant and compliant overread for quality control in both hybrid and supplemental.  Must be extremely detail oriented. Ability to shift responsibilities and be a ‘team player’ is strongly recommended.         Retrieval/Pursuit – 90% retrieval rate; 2 day TAT with chart consolidation and upload, Abstracting – 35 charts per day/95% overall quality score; Research – 25 research activities per day; Overread 40 charts per day/95% quality score
Internal/External Groups with which the Candidate will interface:
Required Skills/Experience:				Preferred Skills/ Experience:
1.	MS Teams exposure			1.	Detail Oriented
2.	Some form of HEDIS knowledge			2.	Working knowledge of QSHR
3.	Excel			3.	Technical Specification exposure
Education Requirement:		HS Diploma		Education Preferred:
Software Skills Required:		MS Office Suite – including Word, Excel
Required Certifications:				Required Testing:		Measure testing

 

About Us: Established in 2004, SPECTRAFORCE® is one of the largest and fastest-growing diversity-owned staffing firms in the US. The growth of our company is a direct result of our global client service delivery model that is powered by our state-of-the-art A.I. proprietary talent acquisition platform, robust ISO 9001:2015/ISO 27001 certified processes, and strong and passionate client engaged teams. We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 140 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation. SPECTRAFORCE is built on a concept of “human connection,” defined by our branding attitude of NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people and clients can reach their highest potential. Learn more at: http://www.spectraforce.com
 
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.

Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.
 
California Applicant Notice: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.
 
LA County, CA Applicant Notice: If you are selected for this position with SPECTRAFORCE, your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer. 


At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $18.00/hr.