Quality Reporting Specialist

Aledade, Inc.; Oklahoma City (OK); Remote; USD 50,000 - 80,000; Full time

Job summary

Join a forward-thinking company as a Quality Reporting Specialist, where your expertise in HEDIS quality measures will drive success in Medicare Advantage and commercial contracts. This remote role offers a chance to make a real impact by ensuring practices receive credit for their services. You'll collaborate with diverse teams, utilize your strong communication skills, and engage in meaningful work that enhances patient care. With a commitment to quality and a supportive culture, this position provides an exciting opportunity to contribute to a transformative healthcare model.

Benefits

Flexible work schedules

Health, dental, and vision insurance

Robust time-off plan (21 days of PTO)

Paid volunteer days

Paid parental leave

Paid sabbatical after six years

Educational assistance program

401(k) with up to 4% match

Stock options

Qualifications

• Experience with Medicare Advantage STARS program and HEDIS measures.
• 1+ years in a primary care setting preferred.

Responsibilities

• Apply HEDIS knowledge to ensure quality measure credit.
• Access practices to retrieve documentation for quality gaps.

Skills

HEDIS quality measures

Communication skills

Attention to detail

Data formatting and reporting

Remote work

Education

Bachelor's degree or equivalent work experience

Tools

Google platform

Excel

Electronic Health Record system

Job description

We are actively recruiting for a Quality Reporting Specialist to join our growing Aledade Performance team. The Quality Reporting Specialist will play a critical role ensuring practice and ACO success in our Medicare Advantage and commercial contracts with a focus on HEDIS quality measures. The Specialist must be service-oriented, well-versed in HEDIS quality measures, and familiar with approaches for reviewing ambulatory care charts both electronic (EHRs) and paper to identify and submit documentation to address quality measure gap closure. This role requires strong attention to detail, great communication skills (both oral and written), and a passion for quality measure performance.

We are looking for individuals who genuinely believe that Aledade’s model of physician-led ACOs can improve quality and lower cost. This role is a remote position with minimal travel requirements.

Responsibilities:

• Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient
• Receive training on payer-specific methods to submit documentation and employ optimal method in each practice (i.e., upload to payor portal, fax, secure email, etc)
• Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with practice staff to guide them through gap closures
• Assist in response to performance improvement plans
• Track quality gap closures per practice and document progress (i.e., X number of gaps addressed through submission during X hour practice visit or remote session)
• Have the capability to generate patient lists and from payer portals and explain to appropriate practice audience (i.e, office manager, care manager, nurse, physician)
• Virtually attend meetings with the Aledade internal team, practice staff and with payers as needed

Qualifications:

• Experience working with the Medicare Advantage STARS program and HEDIS measures
• Bachelor’s degree is preferred or equivalent work experience
• 1+ years experience in primary care setting
• Comfortable working remotely from home/telecommuting
• Travel up to 25% (post pandemic restrictions)
• Computer skills and experience working with Google platform and Excel formulas/pivot tables
• Experience with Electronic Health Record system is preferred
• Comfortable with exporting data, formatting, and reporting out results
• Track and communicate progress; escalate barriers to performance
• Able to work independently and prioritize deadlines
• Strong communication skills

Who We Are:

Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?

At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners

Robust time-off plan (21 days of PTO in your first year)

Two paid volunteer days and 11 paid holidays

12 weeks paid parental leave for all new parents

Six weeks paid sabbatical after six years of service

Educational Assistant Program and Clinical Employee Reimbursement Program

401(k) with up to 4% match

Stock options

And much more!

At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

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