Clever Care Health Plan Is Hiring A Hedis Risk Outreach Coordinator

Join a dynamic team at one of Southern California’s fastest-growing Medicare Advantage plans, making a meaningful impact in healthcare through diversity, innovation, and community-focused care. 🚀

Job Details

• Location: Arcadia Office - Arcadia, CA 91007
• Position Type: Full Time
• Salary Range: $20.00 - $25.00 Hourly

About Us

Who Are We? Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans blend Western medicine with holistic Eastern practices, offering benefits that resonate with our members’ culture and values. 🌿✨

Why Join Us?

We’re on a mission to improve healthcare accessibility for underserved populations. At Clever Care, you’ll have the opportunity to:

• Make a real difference in members' lives 🤝
• Shape the future of healthcare 🚧
• Be part of a fast-moving, innovative organization that celebrates diversity and creativity 🌍💡

Job Summary

The HEDIS/Risk Outreach Coordinator assists in deploying and implementing Stars and Risk adjustment programs, focusing on medical records retrieval and tracking. This role involves collaborating across teams such as Stars, Risk, UM/CM, Provider Relations, and Member Services to schedule appointments, conduct outreach, and support continuous education on HEDIS, Stars, and Risk Adjustment measures to close care gaps.

Functions & Job Responsibilities

• Work with the Stars and Risk team to collect and review member medical records, then document findings in designated databases 📁
• Facilitate provider notifications via fax or phone using reports 📞
• Create PowerPoint presentations and training materials for providers and staff 📊
• Ensure quality improvement documentation is complete and accurate ✍️
• Conduct telephonic and electronic outreach to patients, ensuring HIPAA compliance 🛡️
• Engage members for medication adherence, wellness, HEDIS, and other quality initiative activities 💊
• Identify and work to overcome barriers preventing care gap closure 🛠️
• Coordinate with care team members — including vendors, providers, pharmacists, and nurses — to meet patient needs 🤝
• Perform other duties as assigned to support team goals

Qualifications

Education and Experience

• EMR experience is a plus; travel to provider offices may be required 🌍
• Bachelor’s degree or at least two (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

• Project management and coordination experience with timeline adherence ⏱️
• Strong organizational skills and attention to detail 🗂️
• Excellent communication and writing abilities ✍️
• Proficiency in MS Word, Excel, PowerPoint 💻
• Understanding of HEDIS technical requirements and HCC Risk Adjustment is a plus 🌟

Compensation & Environment

Wage Range: $20 to $25 per hour 💰

Physical & Working Requirements

• Ability to travel as needed 🚗
• Proficient in operating a keyboard, mouse, and phone 📱⌨️
• Ability to sit for long periods, stand, reach, bend, and lift up to 15 lbs 📏
• Work performed in office and remote settings, with frequent staff and public contact 🏢💻
• Occasional irregular hours based on business needs ⏳

Equal Opportunity Statement

Clever Care Health Plan proudly is an Equal Employment Opportunity and Affirmative Action employer. We evaluate all candidates without regard to race, color, national origin, religion, age, sex (including pregnancy and related conditions), sexual orientation, gender identity, marital status, disability, veteran status, or any other legally protected status. Background checks are required. Salary posted is based on California wages and may vary depending on residency. 🌟

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