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MSO HEDIS Representative

Company: Bond Clinic
Location: Winter Haven
Posted on: June 24, 2022

Job Description:

Job DescriptionGeneral Summary of Duties: The MSO HEDIS Representative position is responsible for providing critical analytical support to the Quality Management Director by working up HEDIS Measures and statistics to ensure completion. Responsible include daily chart prep to include PAF or Attestation to primary care physician offices prior to patient appointment. Performing HEDIS medical record reviews, data collection, chart abstractions, reporting and analysis. Coordinates and performs onside medical record reviews and medical record collection at provider offices to support optimum MRA/HEDIS and quality metric reporting.Examples of Duties: (This may not include all of the duties assigned)

  • MRI/HEDIS data collection, analysis, and reporting
  • Analyze and evaluate various sources of data to improve quality and further and goals and objectives of the organization.
  • Research best practices, reports that monitor and benchmarks, and industry standards of care.
  • Develop and produce reports that monitor and benchmark, utilization and other quality and performance indicators.
  • Monitor of adverse trends, recommend modifications and corrective action.
  • Perform medical record reviews, data, collection, chart abstractions, reporting and analysis.
  • Coordinates and performs medical record reviews and medical record collection for each provider to support MRA/HEDIS and quality metric reporting.
  • Provide analytical support to internal departments regarding quality improvement activities.
  • Participate in relevant committees and work groups; make presentations, prepare reports, data or other materials for presentation.
  • Monitor patients in programs offered and work with Primary Care Physicians to ensure overall health needs of patients.
  • Perform all other duties assigned.Knowledge Skills & Abilities: Knowledge base of clinical standards of care, preventative health standards, MRA/HEDIS, and the managed care industry. Candidate must possess strong organization skills and ability to work both independently and with Quality team. Must have the ability to evaluate medial records with attention to detail along with the ability to interact with medical staff, peers, and internal company staff at all levels. Candidate must know how to create and use databases and prepare reports as needed.The ability to demonstrate and assist with focusing activities towards a strategic direction as well as develop tactical plans, drive performance and achieve targets. It is important that candidate be able to show problem solving skills without conflict; the ability to systemically analyze problems, draw relevant conclusions and devise appropriate course of action. Must have good communication skills to interface with virtual or in person meetings and be very detail orientated.Proficiency in software applications that include, but are not limited to Microsoft Word, Microsoft Excel, and Outlook.Education: High School Diploma or GED required.Experience: 1-2 years of experience with healthcare; managed care or HEDIS data analysis. Computer experience required. CMA, LPN, RN preferred, but not required.Certificate/License: Certified Coder, CMA, LPN, RN preferred, but not required if experienced.Bond Clinic is a Drug Free Workplace and an Equal Opportunity Employer. Bond Clinic will provide reasonable accommodation to complete the online application consistent with applicable law. If you require an accommodation, please contact Human Resources.

Keywords: Bond Clinic, Lakeland , MSO HEDIS Representative, Other , Winter Haven, Florida

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