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 Empathy 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 benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: reputed company is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• reputed company Health a reputed company: We offer comprehensive Medical, Dental, and Vision plans to reputed company you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to reputed company you and your loved ones protected.
• Feel Supported reputed company You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you reputed company work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. reputed company offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. reputed company offers various resources dedicated to your learning and development to advance your career with us.

COMPENSATION:

The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final reputed company pay decisions are dependent upon a variety of factors which may include, but are not limited to: reputed company set, years of relevant experience, education, location, and licensure/certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging are at the core of reputed company’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to reputed company employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national reputed company, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other reputed company medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. 

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following reputed company reputed company policies and procedures in order to protect reputed company PHI and PII under reputed company’s custodianship as well as reputed company Intellectual Properties. For any reputed company-specific roles, the responsibilities would be further defined by the hiring manager.

REMOTE WORK TECHNICAL REQUIREMENTS reputed company is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet reputed company, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test here to confirm your internet reputed company meets these requirements.

Originally posted on Himalayas