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Quality Specialist

EPIC Health Southfield
  • Southfield, Michigan
    30+ days ago

    Job Description

     
     
    Quality Specialist 
    Job Description:  
    The ideal candidate for this role is compassionate, flexible, self-motivated, detail oriented, and a constant learner. As a Quality Specialist, you will be the subject matter expert for HEDIS/Gaps in Care measures. You will ensure maintenance of programs for patients in accordance with prescribed quality standards; conduct data collection, reporting and monitoring for key performance measurement activities recognized by the NCQA.  
    Responsibilities: 
     
    • Provides expertise in analysis of data related to supporting value-based programs. Skills include accessing internal databases and tables as well as utilizing Excel skills. 
    • Participates in meetings with vendors for the medical record collection process.  Assists Manager with medical record vendor oversight. 
    ·         Participates in projects to ensure the strategic directives of the stakeholders are executed and time sensitive deadlines met. 
    • Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidence, documentation, and changes.  
    • Monitor, evaluate and report on program status inclusive of scope, schedule, budget and alignment to program and strategic goals.  
    • Direct corrective action, as needed, to maintain the viability of value-based reimbursement Programs. 
    • Provide training and education to staff related to the data available, how to access it, and what metrics might be of interest. 
    Qualifications: 
    ·         Bachelor’s Degree in related field and two (2) years’ experience in the health industry. An equivalent combination of education and experience may be substituted to meet this requirement. 
    ·         HEDIS/Gaps in Care Experience 
    ·         Knowledge of payers and their requirements for each measure 
    ·         Knowledge of Patient Centered Medical Homes and Accountable Care Organizations 
    ·         Microsoft Office Skills 
    ·         The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers. 
    Benefits: 
     
    ·         Tracking key performance indicators 
    ·         We offer a competitive compensation and benefits package including:   
    ·         Bi-Weekly Competitive Pay   
    ·         Opportunities for professional and personal growth   
    ·         Excellent Health Insurance through Blue Care Network with a VIP policy to provide you with affordable access to the best care.   
    ·         Premium Dental and Vision coverage   
    ·         Buy Up Option for Short- and Long-Term Disability, and Life & AD&D Insurance   
    ·         401(k) investment opportunities   
    ·         Generous Holiday, Vacation and Personal time   
    ·         Work/Life Balance    
    Employee Recognition and Assistance Programs   

     


    Numbers & Facts

    LocationSouthfield, Michigan
    Websitehttps://www.epichs.org/join-epic-health/

    Skills

    • Budgetingunmatched
    • Corrective Actionunmatched
    • Data Analysisunmatched
    • Data Collectionunmatched
    • Database Technologyunmatched
    • Detail Orientedunmatched
    • Documentationunmatched
    • Employee Assistance Planunmatched
    • Employee Relationsunmatched
    • Healthcare Effectiveness Data and Information Set (HEDIS)unmatched
    • Medical Recordsunmatched
    • Metricsunmatched
    • Microsoft Officeunmatched
    • National Committee for Quality Assurance (NCQA)unmatched
    • Performance Analysisunmatched
    • Performance Metricsunmatched
    • Process Managementunmatched
    • Quality Metricsunmatched
    • Reimbursementunmatched
    • Status Reportsunmatched
    • Team Playerunmatched
    • Time Managementunmatched
    • Training/Teachingunmatched

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