Remote Healthcare Quality Reporting Specialist

Centene Corp.; Arizona; Hybride; USD 27 000 - 45 000; Plein temps

Avantages offerts par ce poste

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Résumé du poste

Centene Corp. is seeking a Quality Reporting Specialist for a remote role with an on-site Tempe, AZ office visit about once per month. The position involves organizing and assembling quality indicators reported to committees, tracking IAD and QOC data, and preparing QI reports for payor submission.

Education required is a high school diploma or equivalent, with 2+ years in a health care setting coordinating member care. Strong medical/mental health terminology knowledge is needed.

Qualifications

• High school diploma or equivalent.
• 2+ years of experience in a health care setting that includes coordination of member care through physicians, clinical nurses and office managers.
• In depth knowledge of medical/mental health terminology required.

Responsabilités

• Prepare Quality Improvement (QI) reports and submit for review prior to submission.
• Track incident, accident, and death (IAD) reports and correspond to QOC investigations to ensure resolution meets timeliness standards and ensure appropriate information is provided the payor.
• Organize and assemble IAD and QOC data for the QM Committee, the Credentialing Committee, and other entities.
• Ensure that all departments submit reports timely to the Payors.
• Participate in the Risk Committee or other appropriate committees as designated.
• Conduct audits of the State IAD-QOC database to ensure data integrity and timeliness of portal submissions.
• Prepare provider financial sanctions for review prior to submission.
• Serve as primary point of contact to resolve provider issues regarding IADs and QOCs.

Connaissances

Care coordination

Formation

High school diploma or equivalent

Description du poste

Centene Corp. is seeking a Quality Reporting Specialist for a remote role with an on-site Tempe, AZ office visit about once per month. The position involves organizing and assembling quality indicators reported to committees, tracking IAD and QOC data, and preparing QI reports for payor submission.

Education required is a high school diploma or equivalent, with 2+ years in a health care setting coordinating member care. Strong medical/mental health terminology knowledge is needed.