"Alerted.org

Timing: M-F 8am-5pm

Duration: 9 + FTE Possibility

Job Description:

+ Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.

+ Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.

+ Performs provider/location research, clean up, and data updates to ensure that medical record requests are submitted to the right location and PHI is properly handled

+ Conducts HEDIS provider chart request calls, faxes, and mailings.

+ Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measure rates

+ Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes and close gaps in care.

+ Identifies when to refer member to Social Worker or Case Manager.

+ Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.

+ Documents member participation in outreach activities in accordance with abstraction and audit standards.

+ Records and documents all member and provider outreach activity.

+ Performs other duties as required.

Responsibilities:

+ Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.

+ Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.

+ Performs provider/location research, clean up, and data updates to ensure that medical record requests are submitted to the right location and PHI is properly handled

+ Conducts HEDIS provider chart request calls, faxes, and mailings.

+ Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measure rates

+ Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes and close gaps in care.

+ Identifies when to refer member to Social Worker or Case Manager.

+ Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.

+ Documents member participation in outreach activities in accordance with abstraction and audit standards.

+ Records and documents all member and provider outreach activity.

+ Performs other duties as required.

Skills:

+ Chart Abstraction

Experience:

+ Minimum 1 year’s, recent HEDIS project support-related experience

+ Strong communication skills and experience speaking with medical providers.

+ Ability to work independently.

+ Ability to use standard corporate software packages and corporate applications.

+ Computer skills: Microsoft Word, Excel, Outlook, Teams, Adobe Reader, RightFaxPreferred Qualifications

+ Recent and related experience working in health care marketing, member outreach and/or health education experience.

+ Experience working in call center environment

Education:

+ Associate's degree or equivalent experience

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,national origin, disability, or status as a protected veteran.