HEDIS Specialist
Description: We are excited to announce an opening for a HEDIS Specialist. The HEDIS Specialist is responsible for overseeing, planning, and implementing new and existing healthcare quality improvement initiatives and education programs. The HEDIS specialist ensures maintenance of programs for members in accordance with prescribed quality standards; they conduct data collection, reporting, and monitoring for key performance measurement activities. Key Responsibilities:
- Review and abstract medical records to collect data for HEDIS measures.
- Ensure accuracy and completeness of documentation from electronic health records (EHRs) and claims data.
- Maintain detailed logs and tracking systems for data collection progress.
- Prepare and submit HEDIS reports in alignment with NCQA (National Committee for Quality Assurance) standards.
- Monitor compliance with HEDIS specifications and regulatory requirements.
- Assist with internal and external audits related to HEDIS data.
- Identify gaps in care and documentation that impact HEDIS scores.
- Collaborate with providers and care teams to improve performance on key measures.
- Support initiatives aimed at enhancing preventive care and chronic disease management
- Work with clinical, IT, and compliance teams to ensure data integrity.
- Communicate findings and improvement opportunities to stakeholders.
- Coordinate with vendors and external partners during HEDIS season.
- Manage timelines and deliverables for HEDIS-related projects.
- Oversee nurse assignments and vendor activities when applicable.
- Maintain confidentiality and security of patient data throughout the process.
- Manages other duties as assigned.
Requirements:
- High school diploma, Associate’s or Bachelor’s degree in Nursing, Health Information Management, Public Health, or a related field.
- Licensed Practical Nurse (LPN) or Registered Nurse (RN) license (often preferred or required).
- Certified Professional in Healthcare Quality (CPHQ) or RHIT/RHIA credentials are a plus.
- Proficiency in Microsoft Excel, Outlook, and data entry systems
- Experience with HEDIS platforms or EMR systems.
- Strong understanding of medical terminology, ICD-10, CPT, and HCPCS codes.
- High attention to detail and accuracy
- Strong organizational and time management skills
- Ability to work independently and meet tight deadlines
- Effective communication and collaboration with clinical and non-clinical teams
Requirements: About IMA Medical Group: IMA Medical Group is a visionary and dynamic company focused on high-quality primary care services, with doctors and professionals dedicated to the health and well-being of the elderly. With multiple locations throughout Central Florida, we reiterate our commitment to providing quality medical care and an exceptional experience on each visit. That is the peace of mind and convenience that our patients deserve. What We Offer:
- Low-Cost Health, Dental, and Vision Insurance
- 401(K) Retirement Plan with Matching
- Voluntary Short & Long-Term Disability
- Employer-Paid Life Insurance
- Paid Time Off, Floating Holidays, and Paid Major Holidays
- Employee Assistance Program (EAP)
How to Apply: ARE YOU READY TO JOIN OUR TEAM? We understand your time is valuable and that is why we have a very quick and easy application process. If you feel that you are right for this position, please fill out our initial 3-minute, mobile-friendly application so that we can review your information. We look forward to meeting you! IMA Medical Group is an Equal Opportunity Employer (EOE) and we comply with all federal, state, and local anti-discrimination laws, regulations, and ordinances. IMA Medical Group participates in E-Verify, as required by the Florida Medicaid program. IMA Medical Group maintains a drug-free workplace in accordance with applicable Federal and State laws. Apply tot his job Apply To this Job