Providing oversight and direction to the STARS/HEDIS department
Holding staff accountable to Departmental goals
Scheduling and following up on clinical care needs for patients as it relates to Quality Data, including but not limited to Healthcare Effectiveness Data and Information Set (HEDIS)
Managing staff in the STARS/HEDIS Department and assisting staff in quality initiatives, including STAR initiatives
Collecting, reporting, and responding to metrics and contributing to the organization's drive to improve the overall experience of patient care
Reviewing and providing performance feedback to the STARS/HEDIS department
Establishing annual and monthly departmental and individual staff goals
Ensuring the training and on-boarding of new staff
Performing quarterly performance reviews of all Arkos Health STARS/HEDIS staff
Providing education regarding STARS/HEDIS initiatives to staff and outside individuals
Attending Arkos Health educational and demonstration activities, as needed and directed by Executive Medical Director.
Performing the duties of STARS/HEDIS team members, as needed
Reviewing data collected and developing strategies to improve performance
Implementing strategies to improve department performance
Creating, maintaining, and improving written department process flows and procedures
Ensuring gaps in care are captured
Coordinating and ordering preventative and diagnostic tests around gaps in care
Conducting data entry and maintaining appropriate documentation and tracking for quality initiatives
Educating patients on procedures that are being performed
Participating in member chart review by conducting data extraction/collection using Insurance/Medicare guidelines
Collaborating with the PCP in the management and care coordination for members with open gaps of care
Demonstrating the ability to work collaboratively as a high performing quality team member
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 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.
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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