Quality Improvement HEDIS Coordinator

Job Description:

Company Overview

Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com.

Summary Description

Zing Quality Improvement HEDIS Coordinator is responsible for supporting the development and implementation of quality improvement interventions and audits. The QI HEDIS Coordinator acts as a resource on HEDIS measures and assists the Quality Practice Advisor (QPA) to prepare education material for clinical practices and members related to quality measures and compliance. The QI HEDIS Coordinator will assist in resolving deficiencies impacting Zing Health plan’s compliance with State and Federal standards for HEDIS.

Essential Functions

• Supports quality improvement HEDIS and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history
• Collects, summarizes, and trends provider performance data to identify and strategize opportunities for provider improvement
• Prepares and delivers provider specific metrics to help QPA coach providers on gap closing opportunities
• Obtains and prepares medical records for abstracting and overread HEDIS data entry of events
• Performs member and provider outreach to obtain information and medical records to close care gaps.
• Provides resources and educational opportunities to provider and staff
• Documents action plans and details of office visits and outcomes and reports critical incidents and information regarding quality-of-care issues
• Provides communication such as newsletter articles, member education, outreach interventions, and provider education

Qualifications Requirements and Preferences:

• Bachelor's Degree in Healthcare, Public Health, Nursing, Health Administration, Social Work, or related field
• 1 year of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff
• Healthcare Effectiveness Data and Information Set (HEDIS) or CMS Quality measures experience

Required Skills:

Must exhibit an intermediate level of expertise in the following:

• Knowledge of medical terminology and/or experience
• Demonstrated Microsoft Excel Skills
• Demonstrated communication skills; written and oral
• Understanding of data analysis and continuous quality improvement process
• Ability to analyze information and covert related activities into a comprehensive work plan
• Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
• Ability to implement process improvements
• Ability to effectively present information and respond to questions from members, and providers
• Demonstrated analytical skills

Additional Required Skills:

• Strong knowledge of healthcare delivery
• Excellent Communication skills — Listening, speaking, and writing.
• Personal management skills — Plan and manage multiple assignments and tasks, set priorities, and adapt to changing conditions and work assignments.
• Teamwork —the ability to work well with one or more groups.
• Interpersonal effectiveness — Relate to co-workers and build relationships with others in the organization.
• Strong work values — Dependability, honesty, and a positive attitude.

Technical Skills:

• Required intermediate Microsoft Excel
• Required intermediate Microsoft Word
• Required intermediate Microsoft Outlook
• Required intermediate Microsoft PowerPoint

This position offers a competitive salary and benefits, including but not limited to:

• Medical, Dental, and Vision Insurance
• Supplemental insurance (i.e., critical illness, accident, identify protection, pet)
• 401(K)
• Paid-Time-Off (accrued at 4.62 hours per pay period)
• 9 Company Holidays
• Employer paid life insurance ($50,000 flat)