Quality Reporting Specialist

Stellenbeschreibung:

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 using the optimal method for each practice, such as payor portal upload or secure email
Coordinate Electronic Health Record (EHR) system access setup and login management
Consult with market field team members on quality reporting strategy, providing relevant market updates and chart review feedback for assigned practices
Review ambulatory care charts in electronic and paper formats to identify documentation addressing quality measure gaps
Support practice and ACO success in Medicare Advantage and commercial contracts with a focus on HEDIS quality measures

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; elevate barriers to performance
Strong written and verbal communication skills
Strong attention to detail
Bachelor’s degree is preferred or equivalent work experience
G-Suite Proficiency
Experience working with the Medicare Advantage STARS program and HEDIS measures
Sitting for prolonged periods of time
Extensive use of computers and keyboard
Occasional walking and lifting may be required

Core Competencies

Demonstrates expertise in HEDIS quality measures and quality reporting within healthcare settings, with proficiency in Electronic Health Record systems and data management. Strong communication and attention to detail are essential for supporting practice success in Medicare Advantage and commercial contracts.