Clever Care Health Plan Is Hiring A Hedis Risk Outreach Coordinator Bilingual

Join a dynamic healthcare organization committed to diversity, innovation, and making a positive impact in underserved communities. We are hiring a Bilingual HEDIS/Risk Outreach Coordinator (Vietnamese and English) based in Huntington Beach, CA, to support our mission of accessible, holistic healthcare.

🌟 Overview

• Location: Huntington Beach Office - Huntington Beach, CA 92647
• Salary Range: $20.00 - $25.00 Hourly
• Position: Full Time

💡 Job Summary

The HEDIS/Risk Outreach Coordinator will assist with deploying and implementing Stars and Risk Adjustment programs, focusing on medical records retrieval, member outreach, and education. This role involves collaboration across various teams to schedule appointments, close care gaps, and ensure quality improvement initiatives are successful.

🛠️ Functions & Job Responsibilities

• Coordinate with the Stars and Risk teams to gather and review member medical records, entering results into designated databases.
• Notify providers via fax or phone calls using reports, facilitating communication effectively.
• Create engaging PowerPoint presentations and training materials for providers and staff.
• Collect and compile documentation supporting quality improvement functions.
• Perform HIPAA-compliant telephonic and electronic outreach to members to support medication adherence and close care gaps, including HEDIS and CAHPS initiatives.
• Engage members in quality and wellness programs, health risk assessments, and other outreach efforts.
• Coordinate member care by working with vendors, providers, pharmacists, nurses, and care coordinators.
• Conduct warm transfers and identify barriers preventing members from managing their health effectively.
• Assist with other tasks as assigned to support overall organizational goals.

🎓 Qualifications

Education and Experience

• Prior EMR experience is a plus; willingness to travel to provider offices.
• Bachelor’s degree or at least 2 years’ experience in health plan, managed care, or related fields.
• Knowledge of CMS Star Programs, HEDIS, and Risk Adjustment is advantageous.
• Valid driver’s license, reliable transportation, and clean driving record are required.

Skills

• Experience in project management, coordination, and timeline adherence.
• Strong organizational and communication skills, including writing and proofreading.
• Proficiency in MS Word, Excel, PowerPoint.
• Attention to detail and knowledge of HEDIS technical requirements and HCC Risk Adjustment (a plus).

💵 Wage Range

Hourly pay between $20 to $25.

🏢 Physical & Working Environment

• Willingness and ability to travel for work-related tasks.
• Ability to operate a keyboard, mouse, and phone, including repetitive motions.
• Sit for extended periods; stand, reach, bend, and lift up to 15 lbs. when necessary.
• Effective communication skills to convey information accurately and promptly.
• Work may be performed in an office or remote setting with frequent interactions with staff and the public.
• Occasional irregular hours based on organizational needs.

🤝 Equal Opportunity Employment

Clever Care Health Plan is proud to promote a workplace free from discrimination. We welcome applicants regardless of race, color, religion, gender, sexual orientation, gender identity, age, marital status, disability, veteran status, or any other protected status by law. A background check is required.

Note: Salary ranges are based on California wages and may vary depending on residency.