Under the leadership and direction of the Vice President Quality Improvement, the Quality Stars Program Coordinator will focus on the clinical operations for Medicare Star initiatives and other quality improvement initiatives that interface with Clinical Services, Pharmacy, Quality Improvement and the Medical Economics Departments. This position is responsible for data analysis and reporting to identify trends, gaps in care, and opportunities for improvement. Conducts outreach to members and providers to improve adherence to measures. Reviews and analyzing member and provider complaints along with survey results to improve outcomes. Interfaces with the Provider Operations and Provider Experience teams for quality provider initiatives and provider education.
See job description attached.
Required Qualifications:
Responsibilities:
Using the PDSA cycle, identifies barriers and opportunities for improvement related to Star ratings, NCQA, CAHPS and HOS surveys and other member experience or quality metrics Assists to development training and educational material that directly impacts quality initiatives Participates in quality improvement meetings and committees/subcommittees and focus groups
Work Schedule:
8:00am - 5:00pm
The Health Plan, established in 1979, is one of the largest locally managed care organizations in Ohio and West Virginia, serving over 350,000 covered lives. As a federally qualified and state certified 501 (c)(4) not-for-profit HMO, our goal is to provide high quality, comprehensive, and cost-effective health care. Our self-funded division, available in all 50 states, is the fastest growing product within in the organization offerings. The Health Plan is an established and financially secure organization and West Virginia's first and largest HMO.