Quality Reporting Specialist

Apply online at http://www.alohacare.org/Careers/Default.aspx

The Company:

AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors, and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.

The Culture:

AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication.

AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.

The Opportunity:

The Quality Reporting Specialist provides administrative support to the Quality Improvement Department: plans, implements, manages and completes assigned projects with established timelines; performs related work as required or assigned by the Director of Quality. Requirements include broad technical knowledge, strong computer skills, and administrative skills specific to the health care industry.

Primary Duties and Responsibilities:

• Provides support of medical records retrieval efforts including maintenance of EMR access for HEDIS contractors, follows up with facilities, clinics, and providers for EMR access renewal, trains HEDIS contractors on medical records and LTSS records retrieval.
• Assist the Director of Quality in retrieving medical records, providing deliverables to vendors, preparing quality reports, and communication with contractors.
• Assist Quality Management in receiving/tracking and distributing correspondence, mailings or phone calls from providers regarding all Quality programs.
• Assists the Director of Quality in coordinating elements of the HEDIS roadmap, and audit processes; to include administrative support of contacts, provision of data and information to contracted vendors and/or auditors on request, and related assignments.
• Provides administrative support to the QI/HEDIS team for the QI/HEDIS projects, P4P incentive programs, VBP programs, and other quality improvement projects.
• Provides support to the Quality Improvement Department via the coordination and organization of activities and meetings in partnership with both internal and external resources.
• Assists with maintenance of departmental databases and preparation of special projects: mailings, reports, and presentations.
• Assists with the development of projects assigned and ensures effective communication to project team/staff members to fully understand the goals and expectations of the project, and/or assignments given.
• Meets deadlines, timelines, and commitments to ensure completion of projects and/or assignments.
• Assists with the tracking of specific projects by sending reminders to staff, as determined by the QI Managers or Director, e.g., PIPs/QIPs/CCIPs and NCQA Standards.
• Learn to use reporting tools and platforms to produce canned and custom reports as needed, to support the various activities of the department.
• Provides basic data analysis; synthesizes and summarizes information and communicates results to team members to support the various activities of the department.
• All other duties assigned
• Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
• Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Requirements:

• Combination of education, professional training, or work experience which demonstrates the ability to perform the duties of the position.
• Minimum of 6 months of related work experience.
• Proven ability to work well with health care professionals.

• Achieves results, builds trust, communicate effectively, customer and quality focused.
• Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organization.
• Strong, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
• Professional telephonic etiquette skills.
• Ability to solve problems, analyze, think critically, and make good judgments.
• Strong customer service skills and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
• Able to work independently with minimal supervision.
• Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.

• Possesses excellent time management and organizational skills; dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
• Data entry experience with a high degree of accuracy and attention to detail.

• Working knowledge of Microsoft programs: Word, Excel, Outlook and PowerPoint.
• Experience in the operation of general office equipment to include PC, fax/copy machine and phone system.

Preferred Requirements:

• Minimum of 1 year of related experience or equivalent project coordination experience; prior health care experience.
• Experience in project coordination and/or project management.
• Deep desire to work with data and maintain data integrity for all projects.
• Experience with Excel Macros and SQL.

Mental, Physical and Environmental Demands:

• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• In office working environment.
• May require prolonged sitting- up to 4 hours.
• Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled workday.

Salary: $16.50 - $21.00 an hour

AlohaCare is committed to providing equal employment opportunities to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.