HEDIS Operations Coordinator

Description

Responsible for working directly with Primary Care Physician (PCP) offices to ensure their non-compliant diabetic members receive their annual diabetic eye exam to fulfil the NCQA HEDIS quality measure

Essential Functions

Work as the main point of contact for PCP offices to coordinate successful on-site tele-retinal diabetic screenings and member outreach efforts

Validate member eligibility for services using iCare Health Solutions’ proprietary software

Perform initial training and ongoing support for point of contact at PCP offices

Manage and validate non-compliant patient lists sent from health plan partners as well as PCP offices

Coordinate the schedule of HEDIS Technicians for tele-retinal diabetic screenings

Collaborate with team members and management, as well as screening location staff, to form appropriate action plans to meet the client’s needs

Capture and analyze data to drive informed outcomes

Provide outreach to members and assist in the scheduling of appointments with vision providers

Work with business partners to identify process improvements and perform other duties as assigned by management

Requirements

Job Specifications

Typically has the following skills or abilities:

Two to four years of experience in Vision Care or healthcare

Proven ability to build and maintain strong relationships with internal stakeholders and external providers

Excellent interpersonal skills, initiative, and the ability to work both independently and collaboratively

Must be prompt, organized, and have excellent time management capabilities

Ability to work on multiple tasks simultaneously and adapt to changing priorities

Microsoft Word, Excel, and Outlook proficiency; ability to learn company’s software systems

Bi-lingual (English/Spanish) preferred

Strong motivational influence and communication skills 

Excellent written and verbal communication skills and analytical skills 

Working Conditions

The working environment is generally favorable. Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust etc.

The above information in this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability, or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here.