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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Outreach Coord, HEDIS

Primary Location: Fairfax, Virginia
Additional Locations: VA-Fairfax

The Outreach HEDIS Coordinator 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:

  • 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:

  • 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.
  • Ability to travel locally to Provider offices, must have a clean DMV record and reliable means of transportation.
  • Experience working in a professional, corporate office setting.
  • Ability to use standard corporate software packages and Microsoft Office Suite Applications: (Outlook, Work, Excel, PowerPoint, etc.).

Functional Skills:
General Management - Process & quality improvement

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Potential Telework Position:

Percent of Travel Required:
25 - 50%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

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

Candidate Privacy Information:
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.

Click To Review Our Benefits (PDF)


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