- Preparing the annual HEDIS Roadmap and submit to external auditor.
- Preparing the interrator reliability testing and HEDIS measure training for chart auditors
- Supporting the Quality Improvement Director in efforts associated with responding to quality improvement mandates by State, the Federal Government, Accreditation Groups (e.g. NCQA) and Employer Groups (e.g. Health Plan Employer Data Information Set a.k.a. HEDIS).
- Assists in the oversight of Quality Improvement initiatives in the service and clinical area
- Conducting validation audits as directed by the QI Director to ensure the accuracy of the reported HEDIS measures each year as required by various regulatory agencies (i.e. CMS);
- Supports the data needs of the QI Department to include compilation of Daily, Weekly, Monthly and/or Annual Reports;
- In conjunction with the QI Director, revises data collection tools as required (i.e. Site surveys, and Medical Record Documentation audits etc.);
- Attends PHN meetings if requested;
- Performs other duties as requested by the QI Director
- Prepares quarterly reports for QPC or other groups as requested
- Conducts biennial language survey with PH staff and providers
- Scans Primary Source Verification and puts it into Macess
- Ability to develop good working relationships with other departments
- Excellent communication and organizational skills