Job Description
Responsible for coordinating
Quality projects for Value Based Contracts including planning, coordination, scheduling, reporting, and supervision to ensure performance and quality standards are met. Also responsible for external partnership coordination of quality goals and objectives that are in compliance with organization policies and goals. Requires working closely with the management team to coordinate processes between operations.
- Coordinates all external payer meetings to ensure proper parties are represented at monthly and quarterly meetings.
- Responsible for updating payer spreadsheets to ensure all incentive payments are recorded in coordination with finance team.
- Facilitates all VBC quality audits and provides necessary follow up information to leadership and/or payer team.
- Oversee staffing needs including hiring decisions, staff development, performance appraisals, promotions and terminations of quality team.
- Develop direct reports to assure continuity of qualified performance at all levels.
- Responsible for completion of work in a timely manner to meet customer expectations.
- Develops new and on-going procedures and policies for quality projects.
- Coordinates with other departments within ADS in overall effort to secure the highest levels of patient satisfaction.
- Assists operations in facilitation of PI meetings, QI projects including timely documentation and follow up of associated quality activities.
- Bring resolution to difficult problems or situation as necessary for patients, which includes evaluation and documenting complaints.
- Maintains communication with leaders regarding issues involving team operations such as workflow, services, and client development activity.
- Prepares quality VBC performance reports by collecting, analyzing, and summarizing data and trends.
- Participates in Aim 4 Excellence Steering Committee.
- Responsible for coordination of all VBC HEDIS Wellness Day reports and activities in collaboration with Population Health Manager and Operations.
- Additional duties and responsibilities as assigned.
Minimum Qualifications:
- A college degree or equivalent business experience.
- Minimum of two years medical billing and coding experience.
- Minimum of three years customer service experience.
- Proven work record of improving business processes and procedures to maximize
efficiency.
Preferred Qualifications:
- Ability to maintain accurate records and prepare meaningful reports.
- Excellent time management and organizational skills with the ability to handle multiple projects, meet established deadlines and change as business needs require.
- Outstanding interpersonal, customer service, communication and leadership skills with the ability to work independently as well as part of a team.
- Current working knowledge of the healthcare industry and its practices is required.
- Proven decision-making skills with the ability to use sound judgment.
- Proficient working knowledge of communications technology as well as a basic working knowledge of the phone and call software.
- Proficient working knowledge of Word, Excel, Access and working with system development.
- Strong analytical skills, adept in data mining, data analysis and data presentation.
- Strong quantitative skills; possesses advanced Excel skills.
- Ability to establish strong partnerships within all levels in the organization while adjusting communications to the specified audience.
- Ability to communicate complex ideas in clear, succinct terms (written and verbal) for business and process decisions.
Job Type: Full-time
Physical Requirements: •Prolonged periods sitting at a desk and working on a computer.
•Must be able to handle physical demands of installation of telephone system equipment, which may include lifting up to 25 pounds at times. ASCENSION DEPAUL SERVICES
Job Tags
Full time,