HEDIS/STARS Coordinator

HEDIS/STARS Coordinator

This position is responsible for the coordination of HEDIS and Stars program, including gap closure, comprehensive data submission, monitoring and reporting accuracy. The Stars coordinator will be responsible for Stars improvement by supporting HEDIS and Star program data gathering process, completing member & provider outreach as needed, and developing strategies for member experience and quality of service enhancement.

Essential Functions and Duties:

Responsible for formulating/implementing and executing all Star quality program processes, requests, workflows or policies as requested by management in a courteous and efficient manner, including offering a proactive approach to suggestions and recommendations

Download pull lists and perform provider/member outreach as required

Coordinate with provider staff schedule remote or onsite record reviews

Access HEDIS data repository or Ensure Data Solutions to continually monitor areas of improvement on HEDIS gap closure

Create Power Point decks and other training material for internal and external meetings

Develop, monitor and report performance for improvement activities

Attend health plan Joint Operating Meetings (JOM) and other quality meetings

Attend on-site medical group provider meetings regarding quality measures

Additional duties as assigned

Minimum Job Requirements:

High School graduate or GED equivalent; College degree preferred Minimum two-years experience working in a health plan or IPA environment conducting HEDIS/Star activities and/or medical record reviews

Willing to travel locally to provider offices

Skills and Abilities:

Attention to detail and quick learner

Excellent verbal, written communication and interpersonal skills Excellent organizational skills and ability to multitask

Ability to work well in a busy department

Able to stay focused in a fast-paced environment

Preferred qualifications:

2+ years of college, in pursuance of a Bachelor's or Associate's degree in Health Care.

Required Languages:

Bilingual English & Spanish and/or Creole.

What set us apart:

Join Solis Health Plans as a Stars Coordinator and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference.