Healthcare HEDIS/Quality Operations Coordinator - Roseburg

P3 Health Partners, Inc.; Roseburg (OR); Hybride; USD 30 000 - 36 000; Plein temps

Avantages offerts par ce poste

Hybrid work schedule

Résumé du poste

P3 Health Partners, Inc. seeks a Regional Quality Coordinator to lead quality operational support and coordinate across clinics. The role emphasizes HEDIS and pharmacy gap closures, with daily problem solving and meticulous tracking of initiatives.

Reporting to the Market VP with National Quality Manager support, you will engage stakeholders, educate patients on preventative care, and drive performance improvements across providers and pharmacies through telehealth and outreach.

Qualifications

• High school diploma or GED required; associate degree preferred.
• 2+ years in healthcare-related fields; managed care or health plan experience preferred.
• Experience with Word, Excel, PowerPoint and Outlook; basic office equipment proficiency.
• Experience with Electronic Health Records required.
• Medical terminology knowledge and CPT II codes familiarity preferred.

Responsabilités

• Understand CMS, HEDIS, NCQA, Health Plan Quality Standards, CAHPS, HOS, and HIPAA.
• Support Quality Management by improving quality through activities like HEDIS, CMS Star Rating and related reporting.
• Perform telephonic outreach to patients, providers, and pharmacies to discuss opportunities for improvement.
• Improve patient experience and transitions to achieve better health outcomes.
• Collect data through medical records and claims surveillance; support quality initiatives.

Connaissances

CMS/HEDIS knowledge

Quality reporting

Telephonic outreach

Data collection

Coordination across teams

Formation

Associate degree or equivalent experience

Outils

Microsoft Word

Microsoft Excel

PowerPoint

Outlook

EHR systems

Description du poste

Overall Purpose

The Regional Quality Coordinator role is responsible of managing Quality operational support initiatives while overseeing special projects, with a focus on supporting HEDIS and Pharmacy gap closures. This position requires daily problem-solving, meticulous tracking, and coordination across departments to meet varying and changing requirements. The RQC will oversee assigned affiliate groups, providing Quality operational support to clinics to achieve their goals, which may include engaging with internal and external stakeholders with in-person and telephonic outreach to patients for education and engagement on preventative screenings, data mining, medication adherence, and follow-up with primary care providers. This position may directly interact with patients to complete tasks for quality gap closure.

Overall Purpose

The Regional Quality Coordinator role is responsible of managing Quality operational support initiatives while overseeing special projects, with a focus on supporting HEDIS and Pharmacy gap closures. This position requires daily problem-solving, meticulous tracking, and coordination across departments to meet varying and changing requirements. The RQC will oversee assigned affiliate groups, providing quality operational support to clinics to achieve their goals, which may include engaging with internal and external stakeholders with in-person and telephonic outreach to patients for education and engagement on preventative screenings, data mining, medication adherence, and follow-up with primary care providers. This position may directly interact with patients to complete tasks for quality gap closure.

The Regional Quality Coordinator will support the assigned market under the direction of the market VP with the assistance of the National Quality Manager.

Essential Functions

• Understands the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards, CAHPS, HOS, and HIPAA
• Provides support to the Quality Management Department by working with members and network providers to improve quality of care through quality activities such as HEDIS, CMS Star Rating, and other quality performance reporting
• Provides telephonic outreach to patients, providers, and pharmacies to discuss opportunities for optimizing medication use or other opportunities for improvement of healthcare performance measure related issues
• Improves patient experience and transitions for better healthcare outcomes through quality care
• Participates in data collecting through medical record and claims surveillance
• Works to maximize health plan and healthcare provider performance on healthcare related quality measures through effective telehealth communication with patients and coordination with patient caregivers, providers, and pharmacies.
• Assists in planning, implementing, and executing projects to improve quality and delivery of care services
• Using research and knowledge, identifies potential interventions to improve quality strategies
• Participates in Quality Management meetings and other initiatives
• Prepares quality information for presentation to affiliate groups, including groups current standings relative to others and opportunities or improvement
• Point of Contact for provider groups designated by leader
• Leads project management of Quality Fairs, Diabetic Days, and P3 events to maximize quality gap closure
• Subject Matter Expert in P3 machines (diabetic eye camera, bone density machine, etc.)
• Responds to health plan, provider and interdepartmental calls in accordance with exceptional customer service
• Reviews provider group gap uploads through the P3 Provider portal
• Other duties as assigned

Education And Experience

• High school diploma/GED required, associate degree in related field or equivalent experience preferred.
• 2+ years experience in healthcare-related fields required, clinical health care related experience, managed care, or Health plan experience strongly preferred.
• Experience with Microsoft Word, Excel, Power Point, Outlook and general office equipment such as copier, fax machine, required.
• Experience in Electronic Health Records required.
• Medical Assistant Certification or experience as a Pharmacy Tech, Radiology Tech, Lab Tech or similar strongly preferred.
• Experience with data mining is preferred.
• Medical terminology knowledge required, experience with CPT II codes preferred.

Work Conditions

• Availability to travel within assigned region and work from multiple providers offices as needed.
• Must have a valid driver’s license, safe driving record, and able to furnish reliable transportation.

Work Location & Schedule

This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.

Pay range per hour:

$22 - $26 based on experience

About P3

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.

People. Passion. Purpose.

We are looking for a Regional Quality Coordinator. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.