Aetna HEDIS Outreach Coordinator - 49436BR in Philadelphia, Pennsylvania

Req ID: 49436BR

This is an in office position with multiple openings! Looking to fill remaining opening out of Philadelphia, PA. Position offers part time telework potential once training is complete, but all applicants must be comfortable coming and working out of the office.

POSITION SUMMARY

In the HEDIS outreach coordinator position, you will perform provider and member outreach, data analysis, medical record abstraction and data entry to support continuous quality improvement in Healthcare Effectiveness Data and Information Set (HEDIS) rates. Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes. Supports efficient medical record retrieval for HEDIS medical record review and HEDIS supplemental data collection activities.

Fundamental Components include, but are not limited to:

Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measures. Makes outbound calls to members to provide reminders and assistance in obtaining services to avoid delays in treatment and improve member health outcomes. Develops and distributes educational information to members and providers in accordance with the HEDIS outreach work plan. Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation. Documents member participation in outreach activities in accordance with abstraction and audit standards. Conducts HEDIS provider chart request calls and mailings. May develop and maintain member incentive programs to support HEDIS initiatives. May identify opportunities to partner with community organizations on special events and presentations (i.e., health fairs and community events). Works with internal staff to schedule, organize, and staff these events. Records and documents all member and provider outreach activity. Performs other duties as required.

BACKGROUND/EXPERIENCE desired:

Minimum 1 year experience with Healthcare Effectiveness Data and Information Set (HEDIS) data collection and quality improvement activities Minimum 3 years' recent experience working in a health care setting (e.g. managed care, provider office, hospital, clinic, pharmacy, etc.). Strong communication skills and experience speaking with medical providers. Ability to work independently. Experience working in a professional, corporate office setting Ability to use standard corporate software packages and Microsoft applications (Outlook, Work, Excel, PowerPoint, etc.)

EDUCATION

The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

Telework Specifications:

Telework 2 days a week, Office 3 days a week - see notes below on location preferences (requires discussion)

ADDITIONAL JOB INFORMATION

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

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Job Function: Quality Management