Job Description

RTD Talent Solutions is currently representing one of the fastest-growing Medicare Advantage (Part C) organizations in the market. The plan is recognized for delivering comprehensive coverage tailored to the needs of its members, with an emphasis on personalized service. Members benefit from traditional medical coverage as well as enhanced programs such as dental, vision, hearing, wellness initiatives, transportation assistance, prescription drug coverage, and over-the-counter (OTC) allowances. They are seeking a HEDIS/Stars Coordinator.

As the HEDIS/Stars Coordinator, you would be responsible for reviewing medical records, improving documentation practices, and maintaining accurate review activities. You would ensure all submitted data meets HEDIS/Stars specifications while supporting quality initiatives and contributing to a positive, patient-centered care experience. This role is key to enhancing performance, compliance, and overall member satisfaction.

Other key job duties:

• Patient & Provider Support – Deliver excellent customer service by addressing patient and client needs, making scheduling/education calls, and assisting providers with identifying HEDIS/Stars opportunities.
• Quality & Compliance Oversight – Assist with audits, track and trend barriers to care, and communicate challenges impacting outcomes to ensure compliance with HEDIS/Stars standards and close care gaps.
• Collaboration & Continuous Improvement – Partner with leadership and practice staff to identify trends, develop improvement strategies, and maintain an up-to-date knowledge base of HEDIS/Stars requirements.

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