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
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