Clever Care Health Plan · 9 hours ago
HEDIS/Risk Outreach Coordinator (Bilingual Korean or Vietnamese))
Huntington Beach Office - Huntington Beach, CA 92647
Full-time
Hybrid
Entry, Mid Level
$20/hr - $25/hr
2+ years expClever Care Health Plan is one of Southern California’s fastest-growing Medicare Advantage plans, dedicated to making healthcare accessible for underserved communities. The HEDIS/Risk Outreach Coordinator will assist with the implementation of Stars and Risk adjustment programs, collecting and tracking medical records, and coordinating outreach to patients for quality initiatives.
Health Care
Responsibilities
Candidate will work with the Stars and Risk team to collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific database
Facilitate fax or telephone call notification for providers utilizing reports
Create PowerPoint decks and other training materials for providers and staff
Collects and compiles the required documentation to maintain critical quality improvement functions
Telephonic and electronic outreach to patients
HIPAA compliant outreaches to patients for Medication adherence/utilization and other risk/quality gaps closure support including but not limited to CAHPS and HEDIS/Risk gaps
Conducts member outreach for quality initiatives including HEDIS or wellness care gaps, medication adherence, member experience, Health Risk assessments, and other quality related outreach campaigns
May also be required to conducts member outreach from provider office as needed
Warm transfer of any calls to the vendors per the need of the project
Identifying barriers that prevent patients from closing any gaps and work with care team members to help patients be successful in managing their health
Coordinate with members of the patient care team, including vendors, providers, pharmacists, nurses, and patient care coordinators to address patient needs
Other duties as assigned
Qualification
Required
Minimum two (2) years' experience in health plan, managed care or equivalent experience
Valid driver's license, reliable transportation, and insurance required with clean driving record
Prior experience with project coordination and timelines
Demonstrated effective organizational skills
Excellent communication, writing, proofreading and grammar skills
Strong proficiency with MS Word, Excel, Power Point
Excellent organizational skills and attention to detail
Preferred
EMR experience is a plus, must be okay with travel to provider offices
Knowledge of CMS Star Programs, HEDIS is a plus
Knowledge of HEDIS technical requirements is a plus
Company
Clever Care Health Plan
Clever Care Health Plan is a healthcare company that provides health insurance for medicare services.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknown2021-11-01Series Unknown
Leadership Team
Karen Walker Johnson
Interim Chief Operations Officer
Khaliq Siddiq
Chief Medical Officer
Recent News
MedCity News
2025-10-30
Clever Care Health Plan
2025-08-29
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