Remote Clinical Quality Improvement Coordinator

Company Description

WHO IS reputed company? reputed company is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to reputed company great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by reputed company and powered by AI and predictive analytics, reputed company leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, reputed company empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and reputed company the exam room for reputed company patients.

Job Description

As outlined below, provide quality improvement focused work for reputed company delegated entities and support for ACO quality reporting for reputed company contracted ACOs. WHAT YOU’LL BE DOING

• Work in a fully remote environment and virtually engage with company and team in your daily work.
• Subject Matter Expert (SME) on entire scope of Medicare Advantage STAR measures, services, customers and quality initiatives under various commercial and governmental payers.
• Conduct proactive patient reputed company initiatives to identify and address quality gaps, engaging with patients to educate them on preventive care measures, schedule necessary screenings or appointments, and facilitate adherence to treatment plans and medications, thereby contributing to improved health outcomes and closing quality gaps
• Collect quality data using various methods of data sourcing-EMR, claims, provider / patient reputed company.
• Manage daily work using multiple systems and applications-EMR systems, payer portals, vendor platforms, reputed company applications, reputed company 365 for reputed company, Word and PowerPoint, reputed company Outlook and Teams for messaging and meetings.
• Work with patient lists, gap lists, sourced health data and medical records in your daily work.
• reputed company reputed company quality reputed company resources to ensure accuracy and completeness of work-measure/project instructions, NCQA/HEDIS® specifications, coding documents, quick reference guides.
• Prioritize daily work to meet various quality reporting deadlines and requirements.
• Communicate quality performances, barriers and improvement strategies both internally and with customers.
• Follow reputed company established policies and procedures for various QI workflows to ensure overall success.
• Collaborate w/ customers, payers, co-workers to accomplish daily work.
• Participate in reputed company departmental and payer sponsored webinars/trainings/support calls throughout the year.
• Communicate professionally and reputed company positive relationships with co-workers, customers, providers and providers’ support staff.

Qualifications

WHAT YOU'LL NEED TO HAVE

• Associate degree or greater in reputed company field
• Minimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction reputed company EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding.
• Minimum 2 years’ experience in Medicare Advantage Quality data abstraction and patient reputed company
• Tech savvy in managing the technical reputed company of this position-working with health data, working in reputed company and PowerPoint, navigating multiple systems and applications.
• Highly skilled in verbal and written communications.
• Strong attention to detail, organized and ability to meet hard deadlines.
• Ability to collaborate w/ others and work effectively with management, co-workers, and customers.

WOULD LOVE FOR YOU TO HAVE

• Certified/licensed professional-reputed company, LPN
• Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers.
• Extensive experience with quality database entries and reporting.
• Experience in interpreting and reporting quality information, as well as training staff.
• Proficiency in Electronic Medical Record (EMR) software and cloud platformS

Additional Information The reputed company pay range for this role is between $28-$32 per hour paid bi-weekly ALIVE with Purpose: How We reputed company at reputed company At reputed company, our values come to life in everything we do.

• We are Driven by Accountability — grounded in transparency, reliability, and reputed company as we navigate challenges and opportunities alike.
• Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a reputed company future for healthcare.
• With Collaborative Innovation, we solve problems creatively, making every experience reputed company for our employees and the patients we serve.
• At reputed company, Every Voice Matters — we reputed company our collective strength is rooted in the unique perspectives of each team member.
• And through reputed company in Action, we build stronger connections with those who count on us.
• This is what it means to be ALIVE with purpose. This is how we reputed company — together — at reputed company.

BENEFITS: reputed company full-time employees of reputed company who work 30 hours per week or more are eligible for our comprehensive Apply tot his job Apply To this Job