Clinical - HEDIS Coordinator - 210403

Title: HEDIS Coordinator

Location: Hybrid - Delaware (1 New Castle County & 1 Sussex County & 1 Kent County). 2-3 days per week of field work.

Duration: 2 months.

Shift: Mon Fri (8am 5pm EST) No OT & No Holidays

PR: $28-32/hr.

Job Description:

Typical day in a role:

• 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:

• Required: Bachelor's degree in related field or equivalent experience.

Licensure Required:

• Required: Driver's license required and own vehicle.

Years of experience required:

• 3+ years of quality improvement or healthcare related experience.

Disqualifiers:

• no prior HEDIS experience.

Additional qualities to look for:

• Comfortable with travelling to provider offices.

Top 3 must-have hard skills stack-ranked by importance

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.

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.

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.