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The Quality Reporting Specialist plays a critical role ensuring practice and ACO success in our Medicare Advantage and commercial contracts with a focus on HEDIS quality measures. The Specialist must be service-oriented, well-versed in HEDIS quality measures, and familiar with approaches for reviewing ambulatory care charts both electronic (EHRs) and paper to identify and submit documentation to address quality measure gap closure. This role requires strong attention to detail, great communication skills (both oral and written), and a passion for quality measure performance.
Job Responsibility:
Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient
Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with field team to assist guiding practices through gap closures
Submit documentation to health plans and employ optimal method in each practice (i.e., upload to payor portal, secure email, etc)
Coordinates Electronic Health Record (EHR) system access set-up & login management
Consult with market field team members on quality reporting strategy - providing relevant market updates and chart review feedback for assigned practices
Requirements:
1+ years experience in quality reporting in healthcare or health plan setting
Experience working within at least one (1) major Electronic Health Record system (athenaHealth, eCW, etc)
Comfortable exporting data, formatting and reporting out results (Excel or Google Sheets experience)
Able to work independently and prioritize deadlines
Track and communicate progress
escalate barriers to performance
Strong written and verbal communication skills
Strong attention to detail
Nice to have:
Bachelor’s degree is preferred or equivalent work experience
G-Suite Proficiency
Experience working with the Medicare Advantage STARS program and HEDIS measures
What we offer:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
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