Hybrid Quality Manager – STARS, HEDIS

at Arkos Health

• Job title: Quality Manager – STARS, HEDIS
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $80,000 per year
• Degree requirement: Professional Certificate
• Location requirements: Hybrid, Marietta, United States

About the role

• Quality Manager responsible for overseeing STARS/HEDIS department. Ensuring quality data and performance within healthcare environment at Arkos Health.

Responsibilities

• Provide oversight and direction to the STARS/HEDIS department
• Schedule and follow up on clinical care needs for patients as it relates to Quality Data
• Manage staff in the STARS/HEDIS Department and assist staff in quality initiatives
• Collect, report, and respond to metrics
• Review and provide performance feedback to the STARS/HEDIS department
• Establish annual and monthly departmental and individual staff goals
• Ensure the training and onboarding of new staff
• Perform quarterly performance reviews of all Arkos Health STARS/HEDIS staff
• Provide education regarding STARS/HEDIS initiatives to staff and outside individuals
• Attend Arkos Health educational and demonstration activities, as needed and directed by Executive Medical Director
• Review data collected and develop strategies to improve performance
• Implement strategies to improve department performance
• Create, maintain, and improve written department process flows and procedures to improve the functioning of the department
• Ensure gaps in care are captured and coordinate preventative and diagnostic tests around gaps in care
• Conduct data entry and maintain appropriate documentation and tracking for quality initiatives
• Educate patients on procedures that are being performed and the reason for performing them
• Collaborate with the PCP in the management and care coordination for members with open gaps of care
• Demonstrate the ability to work collaboratively, efficiently, and effectively as a high-performing quality team member
• Coordinate and participate in internal and external meetings
• Contribute as an active participant in quality initiatives
• Follow Arkos Health procedures, practices, policies, and guidelines to ensure the safety, security, and well-being of patients
• Perform other duties as assigned to support the overall effectiveness of the organization.

Requirements

• Medical Assistant Diploma and/or Certified Nurse Assistant Certification
• 1+ years’ experience as a manager.
• 2+ years' experience in a healthcare environment
• Recent and related experience working with HEDIS STARS Program
• Experience in Electronic Health Records
• Experience with verifying eligibility and navigating through Insurance Portals
• Experience with CPT II codes
• Basic knowledge HCC’s and Medical Diagnosis
• Ability to perform multiply procedures with training (i.e.) ABI, DRE, Urine Dips
• Familiarity of Medicare guidelines to perform patient screening’s
• Knowledge of medical terminology
• Current unrestricted state driver’s license with personal reliable transportation
• Proof of liability insurance coverage
• Excellent leadership, management, and communication skills with the ability to work collaboratively with other departments and external stakeholders; must be fluent in both spoken and written English and maintain professionalism in all verbal and written correspondence with both internal and external clients.
• Strong ability to self-manage time to manage multiple projects and priorities in a fast-paced environment
• Able to utilize necessary programs to ensure effective communication, collection of metrics, and proprietary software; including but not limited to: Microsoft product suite, Adobe Suite
• Strong analytical and problem-solving skills.

Benefits

• Employer-paid Medical premiums at no cost to you
• Employer-paid Dental premiums at no cost to you
• Employer-paid Vision premiums at no cost to you
• Employer-paid Short-Term Disability premiums at no cost to you
• Employer-paid Life Insurance premiums at no cost to you
• Employer matching 401(k)
• 15 days annual combined sick/vacation during your first year
• 10 paid holidays
• Your Birthday off!