HEDIS Operations Coordinator - Remote

Join Martin's 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 of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community.  Martin's 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 Martin's 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: $65,725.40 - $81,190.20 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.

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact jobinquiries@martinspoint.org

Do you have a question about careers at Martin’s Point Health Care? Contact us at: jobinquiries@martinspoint.org