HEDIS Outreach Coordinator

1 month ago

Los Angeles, United States Regal Medical Group Full time

Perform outbound calls to beneficiaries regarding quality measures and surveying patients on simple health questions. The HEDIS Outreach Coordinator will also assist with inputting authorizations, ordering lab work, scheduling appointments with provider and radiology facilities, contacting provider and other facilities to collect medical records.



** Must be fluent in Spanish and English. **


Essential Duties and Responsibilities include the following:

  • Call beneficiaries to remind them of needed preventative screenings. The goal of these messages are to remind patients, identify if any screenings have already been performed and, if they have not been completed, to assist the beneficiary in any way possible to complete the screenings.
  • Assist beneficiaries by facilitating orders by their appropriate/designated providers.
  • Assist beneficiaries in getting needed diabetic blood work orders from their provider. If requested, will assist them in scheduling appointments with lab centers, if requested.
  • Document all outreaches in internal database.
  • Be very courteous and friendly on the phone and always remember that patients are our most important customer. Our goal is to assist the patient in completing all measures and answering their questions with professionalism, caring and positive attitudes.
  • Assist in contacting providers to retrieve records/documents that confirm quality measures have been completed.
  • Contact beneficiaries to perform basic health screenings such as screening for depression, screening for pain, screening Activities of Daily Living (ADLs), and smoking status.
  • Filing, faxing, copying and scanning of files, as needed.
  • Assist in mailings sent to members and physicians, as needed.
  • Interface with physicians, vendors, members, and internal staff telephonically or in person to obtain data.
  • Interface with data support to receive needed member lists and provider demographics for the department’s outreaches.
  • Ability to manage a heavy workload with frequent interruptions and changing priorities in a fast paced environment.
  • Completes assignments within specified time lines.
  • Able to work well in a team environment on special projects.
  • Skill in working independently, but with supervision.
  • Prepares and maintains records and files that are organized, thorough and readily accessible.
  • Assist in updating policies and procedures.
  • When identifies a problem, informs supervisor in a timely manner so the problem can be corrected.
  • Transmits ideas and information in a clear and concise manner.
  • Assist supervisor with special duties/projects.
  • All other duties as directed by management.



Education and/or Experience:

  • High School diploma.
  • Bilingual in Spanish required.
  • At least 1 year of customer service experience required.
  • One year experience in clinical setting preferred.
  • Familiarity with managed care, commercial and point of service medical care preferred.
  • HEDIS experience preferred.
  • Proficient in Word, Excel, and Access.



The pay range for this position at commencement of employment is expected to be between $24 - $26 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.



The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.



Details of participation in these benefit plans will be provided if an employee receives an offer of employment.



If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.



As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.



Full Time Position Benefits:

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.



Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.




Health and Wellness:

  • Employer-paid comprehensive medical, pharmacy, and dental for employees
  • Vision insurance
  • Zero co-payments for employed physician office visits
  • Flexible Spending Account (FSA)
  • Employer-Paid Life Insurance
  • Employee Assistance Program (EAP)
  • Behavioral Health Services



Savings and Retirement:

  • 401k Retirement Savings Plan
  • Income Protection Insurance



Other Benefits:

  • Vacation Time
  • Company celebrations
  • Employee Assistance Program
  • Employee Referral Bonus
  • Tuition Reimbursement
  • License Renewal CEU Cost Reimbursement Program
  • Business-casual working environment
  • Sick days
  • Paid holidays
  • Mileage



Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

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