HEDIS Operations Coordinator

Join Martins Point Health Care - an innovative not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force ofpeople caring for people Martins Point employees are on amission to transform our health care system while creating a healthier community. Martins Point employees enjoy an organizational culture of trust and respect where our values - taking care of ourselves and others continuous learning helping each other and having fun - are brought to life every day. Join us and find out for yourself why Martins Point has been certified as a Great Place to Work since 2015.

Position Summary

Job Description

PRIMARY DUTIES AND RESPONSIBILITIES

• Serves as the primary liaison for medical record retrieval vendors fostering effective partnerships and coordinating day-to-day operational activities to support HEDIS and quality program objectives.
• Partners with Legal Compliance Procurement and Quality leadership to coordinate vendor contract activities including new agreements renewals amendments and terminations ensuring timely execution and compliance with organizational policies. Investigate and resolve vendor-related issues and grievances monitor corrective action plans and collaborate with internal and external stakeholders to improve vendor performance and service delivery.
• Coordinates medical record procurement activities by documenting record requests monitoring retrieval status tracking receipt of records and maintaining accurate inventory to support HEDIS reporting and audit readiness.
• Coordinates tracks reconciles and validates vendor invoices partnering with Accounts Payable and Quality leadership to ensure timely processing payment accuracy and budget accountability.
• Communicates with provider offices facilities and other record custodians to verify medical record locations resolve procurement barriers and facilitate timely record retrieval.
• Maintains accurate operational reports dashboards and documentation related to vendor performance medical record retrieval invoice reconciliation and project milestones providing routine status updates to leadership.
• Supports HEDIS audit preparedness by maintaining organized documentation validating submission inventories coordinating audit requests and assisting with regulatory and accreditation activities as needed.
• Coordinates cross-functional quality initiatives and operational projects in collaboration with HEDIS Supervisor to maintain and improve workflow efficiency and achieve departmental goals.
• Other duties and responsibilities as needed.

Employees are expected to work consistently to demonstrate the mission vision and core values of the organization.

POSITION QUALIFICATIONS

Education:

• Bachelor Degree or equivalent combination of relevant education and experience

Licensure/certification:

• Medical Assistant Certification preferred
• PMP/PMI certification preferred

Experience:

• 3 year(s) experience in a health care/managed care organization required
• Experience with health plan quality preferred

Knowledge:

• Knowledge of medical terminology healthcare documentation and basic financial tracking processes

Skills:

• Intermediate or greater use of Microsoft office products especially excel word and PowerPoint

Pay Range: $65725.40 - $81190.20 The pay range above reflects the anticipated base pay range based on a full-time position. Actual compensation will be determined based on factors such as experience skills qualifications and other job-related considerations. Employees may also be eligible for additional compensation including incentive or commission-based programs where applicable and subject to the terms of the relevant plan. In addition to base compensation we offer a comprehensive benefits package including medical dental vision retirement savings with employer contributions paid time off (including volunteer time off!) pie day and other employee benefits.

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