95% of all Healthcare Payers engage in the annual NCQA self-audit known as HEDIS. Chasing member records and abstracting those records leads to the NCQA Audit of these self-audits in order to identify compliance with measure related care. Health plans engaging in this audit have their hands full already and then this annual audit comes along. You must staff up with qualified staff, make sure your tech vendor can manage the data and your off to the races between January to May.

While there are many tricky aspects to your annual HEDIS project, here’s some process we’ve instituted to ensure qualified, and reliable staff are available to our clients. While this model discusses HEDIS we do a variety of other staffing for a multitude of firms. The components are different, but the model is the same.

The Job Posting

Job descriptions and job postings of this sort can be difficult for the supplier, the client, and the future employee/subcontractor alike. It is difficult to put into words the different expectations of these three groups and their interpretation of the need. The supplier should be considering the expectations of the client and considering the ways to vet out these expectations through interview, testing, background checks and the like. The client wants to express their entire need which can be cumbersome to read and comprehend and is often incomplete. Finally, the candidate is left to interpret the reality of the actual needs of the job from the job post and future interactions with the supplier. Once in our portal reading the job description the candidate may upload a resume and answer several key questions.

These “questions” should be eliminators or at least highlighting your concerns. As an example, with the large amount of work that goes into one person in terms of VPN/RSA access, on-boarding, training, and guidance it is very expensive to have a candidate do all of this and then say, “I can’t continue because….” The because is often a personal matter such as school, work, care for a family member, or some detail that should have been teased out in this early phase. Choose five to six questions that show your need and that indicate an upcoming truthful discussion by both parties during the interview.

Candidate Review

Candidate reviews begin with our review of their pre-application elimination questions. These questions help us properly vet the individual.

Next, we’ll review the resume. First, and it’s sad to say, consider the outdated aspects of this resume. For us in a Staffing Firm, it is shocking how many poorly done and outdated resumes we see. If the resume is outdated in a field where you’re asking your staff to skillfully pay attention to the details, you have your first conundrum. How do I interpret a poorly done or outdated resume? Unprofessional? lack of resume building skills? Laziness? It’s hard to come up with a reasonable response. Second, if the content of the resume is good enough, we’ll start to compare notes to their earlier pre-application questions, looking at the recent seasons working, and with HEDIS, the actual work done. This is critical because we want to know what you can do in terms of abstraction, over read, administration, data analytics, and so on.

Vetting Stage #1

This is a brief getting to know your introduction call. Here again we’ll want to be looking for red flags. The mention of obligations that contradict their pre-application questions. We then give a brief overview of the position and allow for questions. Once both parties are satisfied that we can and should move forward we’ll advance the candidate to the testing phase.

The HEDIS Measure and Abstraction Test

Medlinks uses a copyright Measure and Abstraction test to measure two very different skill sets. Measure knowledge and Abstraction knowledge. Each test is timed at 45 minutes from the start with allowable pausing features. Each test is shuffled so that Q&A cannot be easily shared among test takers. The test tabulates scores by HEDIS measure. This allows for the client to see the candidates tested strengths and weaknesses. The measure an abstraction test is tuned to the year of the HEDIS measures and its corresponding season.

Candidate Submission to Client

Candidate submission has finally come with the completion of two successfully passed tests signifying a qualified candidate. This submission includes their updated resume, their submitted application questions, their test scores broken out by measure, and any notes we have from their initial interview.

The client can now ask questions for vetting stage # 2 or they can accept or reject the candidate

Vetting Stage #2

The second interview takes place after a candidate submission has been met positively by the client. This interview is much more critical than the first and the “message” should be conveyed that the job offer is occurring and the details of work, schedules, timelines, milestones, expectations, and the rest should be an integral part of the discussion. The candidate should be encouraged to ask questions here and the entire interview should end with a review of your pre-application process.

On Boarding and Retention

Finally, and no less important, is the on-boarding process and the mandate to retention. The on-boarding process should be clean and easy for the end user. There are many ways to do this, but we’ve found a variety of software solutions that assist in the management of the correct on-boarding procedures. Retention is the bigger job and the job of a good staffing agency is the “human factor.” Things happen. People have issues come up. These need a balanced approach

Closing Thoughts

In closing, this is a brief overview of our process but to define its value we will have 100 applicants who:

  • apply for the job
  • schedule an interview
  • must use a calendar link to schedule this interview
  • Must “show up” to the interview
  • Must pass 2 comprehensive tests
  • Must schedule and show up for a final vetting interview
  • Manage the required components of the on-boarding process

At the end of the day 15-19% of what looked like quality staff make it through the process successfully. Through this process they must use professionalism, computer literacy, (if only slightly) knowledge in separate categories, and tenacity in getting through the process. These are HEDIS skills for sure and this is how we deliver the “cream of the crop” to our HEDIS Project clients.

We also have productivity and Quality software to track your staff’s abilities during the project run!! To learn more visit us at www.medlinksstaffing.com or to apply visit us at https://www.optum.com/about/news/2019-executive-survey.html?o=optum:PaidSocial:AE_20.7_2019:LI:CO:LRN:193m5p309ws05:n_a:n_a:n_a:n_a:n_a