Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you? Showing Up Somatus Strong We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say. Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more. Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests. Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions. Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners. Showing Up for You We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including: Subsidized, personal healthcare coverage (medical, dental vision) Accrual of 3 weeks’ Vacation (PTO) Professional Development, CEU, and Tuition Reimbursement Curated Wellness Benefits supporting teammates physical and mental well-being Community engagement opportunities And more! The Clinical HEDIS Coordinator I will perform the functions related to the outreach, collection, and accurate data entering of medical records and service data according to HEDIS / Somatus Technical Specifications. The primary focus of this role will be to analyze and process the information collected and review the applicable medical records and clinical criteria. Responsibilities Coordinate, complete, and update management on all HEDIS processes and results. Work with providers and internal departments on rate investigation and validation activities, which includes maintaining all evidence, documentation, and changes. Call patients to schedule appointments, develop recommendations for quality improvement activities for our providers and collaborate with other departments on these activities. Complete review of medical records received from providers and be responsible for attestations within contract portals. Engage positively with members, peers, and clinic staff. Collect and enter clinical information from medical records into various tools and databases in accordance with HEDIS technical specifications as well as Somatus and health plan specifications. Remain updated on NCQA HEDIS Technical Specifications as it applies to Somatus and partner health plan quality programs. Interface with data support, quality assurance team, HEDIS Quality Manager, and IT to collect data and maintain the various health plan tools. Formatting, faxing, copying, and uploading of files. Strive to meet personal, departmental, and organizational goals and targets. Complete assignments within specified timelines. Prepare and maintain records and files that are organized, thorough and readily accessible. Attend team meetings and report findings of data collection as well as barriers or opportunities. When a problem is identified, inform supervisor in a timely manner. Transmit ideas and information in a clear and concise manner. All other duties as directed by management. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Qualifications Required Education and Experience: Required Licensed as a Practicing or Vocational Nurse. 1-3 years experience working in HEDIS or medical records. Ability to manage a heavy workload with frequent interruptions and changing priorities in a fast-paced environment. Able to work well in a team environment on special projects Skilled in working independently with minimal supervision. Strong communication skills (written and verbal) to effectively communicate across teams, levels and functions. Strong organizational and time management skills. Ability to give and receive feedback and constructive criticism. Candidates must also have very strong presentation skills using tools like PowerPoint, Excel, etc. along with the ability to create compelling and dynamic presentations. Preferred 1-3 years HEDIS experience preferred. Knowledge, Skills, and Abilities: Ability to document and analyze complex business requirements and processes Ability to interface with Senior Level Executives during client meetings I presentations Must be a proactive, hands-on leader with a proven strategic vision who will drive operational performance with a high degree of accountability and integrity Strong analytical skills Acute attention to detail Ability to be both a strategic and tactical change agent in the healthcare space Self-starter who will take initiative and be proactive when there are multiple priorities Strategic solution-seeker who sees opportunities when others see barriers Strong interpersonal skills and ability to communicate effectively Ability to handle ambiguity and desire to work in a fast-paced start-up environment Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.