QI Data Coordinator - Medicare Advantage

Guidehealth; Dallas (TX); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking healthcare company that is dedicated to making healthcare affordable and improving patient health. In this fully remote role, you will be engaged in quality improvement initiatives, acting as a Subject Matter Expert on Medicare Advantage STAR measures. Your proactive outreach to patients will help close quality gaps and enhance their care experience. You'll work with a supportive team, utilizing your skills in data abstraction and communication to drive positive health outcomes. This is an exciting opportunity to make a meaningful impact in the healthcare sector while enjoying a flexible work environment and competitive compensation.

Benefits

Flexible Time Off

Competitive Compensation

Remote Work Equipment Provided

Qualifications

• 1-3 years of experience in a healthcare setting with EMR systems.
• Associate degree or greater in a related field required.

Responsibilities

• Conduct proactive patient outreach to improve health outcomes.
• Collect quality data and manage daily work using multiple systems.

Skills

Verbal Communication

Written Communication

Attention to Detail

Organizational Skills

Collaboration

Technical Proficiency

Education

Associate Degree

Bachelor's Degree

Tools

EMR Systems

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Microsoft Teams

Job description

WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.

Job Description

REMOTE

As outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs.

What You’ll Be Doing

• Work in a fully remote environment and virtually engage with company and team in your daily work.
• Subject Matter Expert (SME) on entire scope of Medicare Advantage STAR measures, services, customers and quality initiatives under various commercial and governmental payers.
• Conduct proactive patient outreach initiatives to identify and address quality gaps, engaging with patients to educate them on preventive care measures, schedule necessary screenings or appointments, and facilitate adherence to treatment plans and medications, thereby contributing to improved health outcomes and closing quality gaps.
• Collect quality data using various methods of data sourcing-EMR, claims, provider/patient outreach.
• Manage daily work using multiple systems and applications-EMR systems, payer portals, vendor platforms, Guidehealth applications, Microsoft 365 for Excel, Word and PowerPoint, Microsoft Outlook and Teams for messaging and meetings.
• Work with patient lists, gap lists, sourced health data and medical records in your daily work.
• Leverage all quality related resources to ensure accuracy and completeness of work-measure/project instructions, NCQA/HEDIS specifications, coding documents, quick reference guides.
• Prioritize daily work to meet various quality reporting deadlines and requirements.
• Communicate quality performances, barriers and improvement strategies both internally and with customers.
• Follow all established policies and procedures for various QI workflows to ensure overall success.
• Collaborate with customers, payers, co-workers to accomplish daily work.
• Participate in all departmental and payer sponsored webinars/trainings/support calls throughout the year.
• Communicate professionally and develop positive relationships with co-workers, customers, providers and providers’ support staff.

Qualifications

WHAT YOU'LL NEED TO HAVE

• Associate degree or greater in related field.
• Minimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction via EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding.
• Minimum 2 years’ experience in Medicare Advantage Quality data abstraction and patient outreach.
• Tech savvy in managing the technical side of this position-working with health data, working in Excel and PowerPoint, navigating multiple systems and applications.
• Highly skilled in verbal and written communications.
• Strong attention to detail, organized and ability to meet hard deadlines.
• Ability to collaborate with others and work effectively with management, co-workers, and customers.

WOULD LOVE FOR YOU TO HAVE

• Certified/licensed professional-CMA, LPN.
• Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers.
• Extensive experience with quality database entries and reporting.
• Experience in interpreting and reporting quality information, as well as training staff.
• Proficiency in Electronic Medical Record (EMR) software and cloud platforms.

What You Get

• Use your skills to make a meaningful impact in healthcare.
• Work with a great team in an awesome work environment.
• Competitive compensation.
• Great benefits like flexible time off.

COMPENSATION

The base pay range for this role is between $28-$32 per hour paid bi-weekly.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Remote Work Technical Requirements

Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The recommended internet speed is a minimum of 50 mbps download, 10 mbps upload.