HEDIS Coordinator - 210403
- 🇺🇸 United States
- On-site
- 1 day ago
- HEDIS
- HIPAA
- EHR
- EMR
Looking for 1 candidate per location.
1 - New Castle County
1 - Kent County
1 - Sussex County
Shift :Mon - Fri, 8am - 5pm EST, NO OT, No Holidays
Target Start Date :16 Nov 2026
Duration : 2 months
Description: Job Profile Summary Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results
Establish and maintain an action plan to improve HEDIS scores
Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidences, documentations, and changes
Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality
Conduct quality audit and maintain all data and process controls to ensure compliance
- Travel on site to provider offices to retrieve medical records for HEDIS
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Performance expectations: 1. 100% adherence to HIPAA 2. Retrieved records meet HEDIS criteria, are within required timeframe are legible, and complete. 3. Accurate indexing and naming of records, 4. Timely escalation and resolution of provider barriers affecting retrieval, 5. Maintain professional relationships with office staff and providers
This role offers a unique opportunity to combine healthcare quality expertise with direct provider engagement. Unlike traditional office-based positions, the Medical Record Retrieval Specialist works directly with provider offices to obtain critical medical records that support HEDIS reporting, quality improvement initiatives, and better health outcomes. The role requires a blend of relationship-building, problem-solving, travel, and technical knowledge of medical records, EHR systems, and HEDIS measures, making a tangible impact on both provider performance and member care.
·Education/Certification
Required: Bachelor’s degree in related field or equivalent experience.
Preferred:
Licensure
Required: Driver's license required and own vehicle
Preferred:
Years of experience required: 3+ years of quality improvement or healthcare related experience.
Disqualifiers: no prior HEDIS expeirence
Additional qualities to look for: Comfortable with travelling to provider offices
· Top 3 must-have hard skills stack-ranked by importance
1
HEDIS Measures and Quality Improvement Knowledge
- Understanding of HEDIS measure requirements, medical record documentation standards, and quality gap closure opportunities.
- Ability to identify records and documentation needed to support measure compliance and improve quality outcomes.
2
Medical Record Retrieval and Documentation Management
- Ability to locate, request, collect, organize, and securely transmit medical records from provider offices.
- Understanding of medical record components, dates of service, and documentation requirements needed to support quality measures.
- Experience working with EMRs, provider portals, fax systems, scanning, and document management tools.
3
HIPAA Compliance & Healthcare Regulations
- Knowledge of HIPAA, PHI handling, and data privacy requirements.
- Ability to securely transport, store, scan, and transmit confidential patient information.
- Understanding of audit and compliance standards related to medical record collection and quality reporting.
HEDIS Coordinator - 210403 · Axelon Services Corporation