Quality Specialist Ambulatory – Managed Care

01 Silver Cross Hospital and Medical Centers; New Lenox (IL); Hybride; USD 49 000 - 63 000; Plein temps

Avantages offerts par ce poste

Medical, Dental and Vision plans

Life Insurance

401(k) plan with a match

PTO and Sick time

Wellness program

Tuition Reimbursement

Résumé du poste

Silver Cross Hospital in Illinois seeks an experienced professional to create and implement a vision for improving quality clinical outcomes in private practice settings, in collaboration with Senior Leadership. You will coordinate care plans, close care gaps, and help align policies with quality goals for enrollees.

You will work with multiple service lines to influence HEDIS and Star ratings, partnering with clinical leadership to drive transformation, education, and robust training outcomes

Qualifications

• Education and Training: Bachelor's degree in Business, Healthcare Administration, or related field required.
• 3-5 years clinical practice experience or experience improving clinical quality outcomes required.
• Excellent verbal, written, presentation, computer, and interpersonal communication skills.

Responsabilités

• Subject matter expert regarding the HEDIS product line.
• Represent the Clinical Integration product for client and internal meetings.
• Collaborate with affiliate service lines to impact HEDIS and Star ratings and provide seamless client service.
• Work with the Chief Medical Officer to align clinical, quality, and medical management processes with targets for enrollees.
• Promote linkage between utilization management, care coordination and quality improvement with partnered MSO.
• Model education, development and adoption of practice transformation focusing on workflow, satisfaction, RAF scores.
• Collaborate with Director Value Based Care and Innovista while communicating with CMO and Senior Leadership.
• Oversee clinical training activities and outcomes.

Connaissances

Verbal communication

Written communication

Presentation skills

Interpersonal skills

Computer skills

Formation

Bachelor's degree in Business, Healthcare Administration, or related field

Outils

MS Word

Excel

Outlook

PowerPoint

Description du poste

Silver Cross Hospital is an extraordinary place to work. We’re known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve…and for each other. Come join us! It’s the way you want to be treated.

Position Summary

Position will be responsible for creating, implementing, and maintaining a vision and plan for providing improved quality clinical outcomes to patients in the private practice setting, in collaboration with the Senior Leadership team.

We will work with all practices of SCHC on closing care gaps, helping practices, hospital, and ancillary sites in coordinating patients’ care plan, and work side by side with clinical leadership in creating Quality strategy moving forward.

Essential Duties and Responsibilities

• Subject matter expert regarding the HEDIS product line
• Represent the Clinical Integration product for both client and internal business process meetings
• Collaboration with all affiliate service lines to impact HEDIS and Star ratings and to provide seamless client service
• The position works closely with the Chief Medical Officer to ensure effective clinical, quality, and medical management operational processes and policies that align with targeted quality outcomes and goals for enrollees
• Promotes linkage between utilization management, care coordination and quality improvement activities with partnered MSO
• Acts as a role model for clinical staff, promoting education, development and adoption of practice transformation with focus on clinical workflow, member satisfaction, improved RAF scoring
• Promotes collaboration while working closely with Director Value Based Care and Innovista, in conjunction with maintaining appropriate communication with CMO and Senior Leadership Development, and implementation of Policies and Procedures for Clinical Operations in the clinical office setting
• Responsible for oversight of clinical training activities and outcomes.

Required Qualifications

• Education and Training: Bachelor's degree in Business, Healthcare Administration, or related field required.
• 3-5 years clinical practice experience or experience improving clinical quality outcomes required.
• Excellent verbal, written, presentation, computer, and interpersonal communication skills.

Highly Desired

• ICD-10-CM/PCS Coding training and certification
• 3-5 years clinical practical experience
• 2-3 years CM, discharge planning and/or home health care coordination experience
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently (remote working)
• Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.
• Efficient and Effective computer skills including navigating multiple systems and keyboarding

Work Shift Details

Days, Days Department: CLINICAL DOCUMENTATION

Benefits for You

• Medical, Dental and Vision plans
• Life Insurance
• Flexible Spending Account
• Other voluntary benefit plans
• PTO and Sick time
• 401(k) plan with a match
• Wellness program
• Tuition Reimbursement

Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However, registry employees are ineligible for Health and Welfare benefits.

The expected pay for this position is listed below: $35.76 - $45.60

The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.

INSPIRING HEALTHY RELATIONSHIPS THROUGH AN INCLUSIVE CULTURE AT SILVER CROSS. Silver Cross