Hybrid HEDIS Coordinator {178417}

A-Line Staffing is now hiring a Full-time Hybrid HEDIS Coordinator in Eugene, OR. The Hybrid HEDIS Coordinator would be working for a Fortune 500 Managed Care company and has career growth potential. This would be full time / 40+ hours per week.

If you are interested in this Hybrid HEDIS Coordinator position, please apply to this posting for Immediate Consideration!

Hybrid HEDIS Coordinator Compensation

• The pay range for this position is $25-$30 per hour plus mileage reimbursement

Schedule:

·         Monday – Friday 8am-5pm PST

Location: Mostly remote work with potential for occasional Field visits to provider offices in the area.

Position Summary:

Implement a limited, outcome-based Member Navigation Program for identified Oregon Medicare members with verified open gaps in specified HEDIS measures. Increase HEDIS gap closure for selected measures through after-hours contact, direct appointment scheduling, reminders, referral navigation, and verified completion tracking paired with expanded-hours appointment access. Focus measures include Breast Cancer Screening, Controlling High Blood Pressure, Colorectal Cancer Screening, Diabetes – Dilated Eye Exam, Diabetes HbA1C Control, Kidney Health Evaluation for Patients with Diabetes, Osteoporosis Management in Women Who Had Fracture, Transitions of Care, and Follow-Up After Emergency Department Visit for People with High-Risk Multiple Chronic Conditions.

Baseline numerator, denominator, performance rate, open-gap count, data source, and as-of-date participating-group and program levels are to be confirmed before launch. Evaluate the intervention using successful contact rate, appointment scheduling rate, kept-appointment rate, verified service-completion rate, incremental compliant gaps closed. Measure-specific HEDIS compliance improvement is the quality outcome.

Hybrid HEDIS Medical Record Retrieval Specialist Responsibilities

The proposed Member Navigator role would provide hands-on, nonclinical support to eligible Oregon Medicare members with verified open HEDIS care gaps. The navigator would help members move from an identified service need to a scheduled appointment, completed service, and documented follow-up. Work would include member outreach, barrier assessment, appointment scheduling, referral navigation, reminders, and coordination with participating practices and the program’s data-validation team.

Day-to-day responsibilities

• Review current member worklists and confirm eligibility, attribution, open-gap status, and existing appointments before outreach.
• Contact members through approved channels, including evening or weekend outreach when permitted and consistent with member preferences.
• Identify scheduling, geographic, and care-coordination barriers and help members navigate available service options.
• Schedule appointments where access is authorized or provide warm transfers to practice scheduling teams.
• Coordinate access to confirmed early-morning, evening, and Saturday appointments.
• Provide appointment reminders, reconcile attendance, and help members who miss visits reschedule.
• Track referral and documentation status, record outreach outcomes, and escalate unresolved clinical follow-up to the responsible practice.
• Keep outreach, scheduling, attendance, service completion, and validated gap closure distinct in program tracking.

 What makes the role unique

This role bridges member outreach, practice scheduling, and quality reporting rather than stopping at a reminder call or referral. It combines personalized navigation with expanded-hours appointment access and continued follow-through. Its focus is verified completion of qualifying care—not outreach volume alone. The navigator supports coordination; providers retain responsibility for clinical decisions, results review, and clinically indicated follow-up.

Hybrid HEDIS Medical Record Retrieval Specialist Requirements

·         High school diploma required. Bachelor’s Degree strongly preferred

·         Valid driver’s license and clean driving record along with a reliable vehicle

·         3+ years of HEDIS experience

·         3+ years of quality improvement or patient-facing healthcare related experience

·         Comfortable travelling to provider offices

·         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.

·         Ability to locate, request, collect, organize, and securely transmit medical records from provider offices

If you think this Hybrid HEDIS Medical Record Retrieval Specialist position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!