Clover Health - HEDIS Measure Owner (Abstractor)

• Own assigned HEDIS measure(s) with accountability for 5-Star performance. • Monitor performance regularly, including: current rates and trends, gap-to-goal analysis, hits needed to achieve target performance. • Review and abstract medical records as they are received. • Maintain productivity expectations of 60–80 charts per day. • Document findings accurately and aligned with NCQA HEDIS technical specifications. • Conduct random audits of incoming data streams to validate completeness and accuracy. • Partner with providers & clinical teams to close care gaps • Provide insight into chart findings, documentation gaps, and missed opportunities. • Act as a liaison between abstraction, clinical, and provider workflows. • Validate data & collaborate cross-functionally to improve accuracy. • Collaborate with data and analytics teams to: validate accuracy of data sources and identify gaps between claims, supplemental data, and chart findings. • Serve as a subject matter expert (SME) on HEDIS measures and requirements. • Serve as SME for grouping of assigned HEDIS measures across women's health, cardiovascular health, diabetes care, care transitions and management, or preventive screening. • Maintain deep knowledge of: HEDIS technical specifications, Medicare Advantage STAR ratings, value sets and documentation requirements. • Provide guidance to internal teams on measure interpretation and compliance. • First 90 days: Rapidly ramp on the Clover Assistant platform and assigned HEDIS measures, consistently reviewing 60-80 charts per day with strong accuracy. Begin contributing to gap closure by identifying care gaps and reliably translating findings into compliant, high-quality outputs. • First 90 days: • First 6 months: Proactively surface care gaps, near misses, and incomplete services, and convert insights into actionable provider interventions within CA and EHR workflows. Partner cross-functionally to improve gap closure strategies, refine provider alerts, and enhance data and reporting logic. • First 6 months: • First year: Drive meaningful improvements in quality performance, including progress toward 5-Star measures, while reducing provider administrative burden. Prioritize high-impact actions that streamline workflows, minimize unnecessary documentation, and enable providers to focus more on patient care. • First year: • You should get in touch if: • You have at least 2+ years of HEDIS Abstraction Experience. • You have strong knowledge of Medicare Advantage and HEDIS measures and technical specifications. • You have strong analytical and problem-solving skills. • You have accountability and ownership mindset. • You have strong attention to detail, data, and documentation accuracy. • You have effective communication and collaboration. • You have the ability to translate data and chart findings into actionable insights. • You have the ability to work effectively in a remote environment. • Associate’s or Bachelor’s degree in healthcare-related field (or equivalent experience). • Experience with HEDIS abstraction tools. • Experience working with EHR systems and provider workflows. • Exposure to STAR ratings performance strategy.