Quality Reporting Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Utilize your understanding of HEDIS quality measures to address incentivized contract metrics across various Medicare Advantage and commercial health plans, ensuring that practices and ACOs receive acknowledgement for services provided to patients.

• Conduct in-person or remote evaluations of practices to gather documentation aimed at closing quality gaps, and collaborate closely with the field team to guide practices in fulfilling these gaps.

• Submit documentation to health plans using the most effective method for each practice, such as payor portal uploads or secure email communications.

• Manage the setup of Electronic Health Record (EHR) system access and oversee login administration.

• Collaborate with market field team members to discuss quality reporting strategies, providing pertinent market updates and feedback on chart reviews for designated practices.

• Analyze ambulatory care charts in both electronic and paper formats to pinpoint documentation that addresses quality measure deficiencies.

• Assist practices and ACOs in achieving success in Medicare Advantage and commercial contracts, with a strong emphasis on HEDIS quality measures.

⛳️ Requirements

• Minimum of 1 year of experience in quality reporting within a healthcare or health plan environment.

• Familiarity with at least one major Electronic Health Record system (such as athenaHealth, eCW, etc.).

• Proficient in exporting data, formatting, and presenting results (experience with Excel or Google Sheets is necessary).

• Capable of working independently while effectively prioritizing deadlines.

• Able to track and communicate progress, and escalate any performance barriers.

• Excellent written and verbal communication skills.

• Strong attention to detail.

• A Bachelor’s degree is preferred, or equivalent experience in a relevant field.

• Proficiency in G-Suite applications.

• Experience with the Medicare Advantage STARS program and HEDIS measures is advantageous.

• Ability to sit for extended periods.

• Significant use of computers and keyboard required.

• Occasional walking and lifting tasks may be necessary.

🏝️ Benefits

• Flexible work schedules and the opportunity to work remotely are available for many positions.

• Health, dental, and vision insurance coverage paid up to 80% for employees, their dependents, and domestic partners.

• Comprehensive time-off policy (21 days of PTO in the first year).

• Two paid volunteer days and 11 paid holidays each year.

• 12 weeks of paid parental leave for all new parents.

• Six weeks of paid sabbatical after six years of service.

• Educational Assistance Program and Clinical Employee Reimbursement Program.

• 401(k) plan with up to a 4% employer match.

• Stock options available.

• Remote-first work culture.