Specialist, Quality

Suvidahealthcare; Dallas (TX); On-site; USD 50,000 - 70,000; Part time

Benefits offered by this job

Competitive Pay

Free Mental Health & Life Coaching

Generous Paid Time Off (PTO)

401k Retirement Plan with Company Match

Job summary

Suvida Healthcare in Dallas, Texas, is looking for a Specialist, Quality to enhance care quality for Medicare-eligible Hispanic seniors. In this role, you'll collaborate with clinic staff to address care gaps, conduct audits, and educate on HEDIS specifications.

The ideal candidate will hold a relevant Bachelor's degree and have extensive experience in value-based care settings. Enjoy competitive pay and unique benefits in a meaningful work environment.

Qualifications

• Bachelor's degree required in healthcare administration or public health.
• Must have 4+ years of experience in value-based care setting.
• At least 2 years of HEDIS or Risk Adjustment experience.

Responsibilities

• Identify quality gaps and notify clinical staff of next steps.
• Audit and submit documentation to close quality gaps.
• Educate staff on HEDIS technical specifications.

Skills

Ability to work independently

Problem-solving skills

Ability to multi-task

Fast-paced environment adaptability

Education

Bachelor's degree in healthcare administration or public health

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Job description

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors.

What Makes Us Unique

We are an empowered primary care team, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well-being of the seniors we serve.

How We Work

Our Culture & Core Beliefs

• Earn Trust
• Building Relationships
• Creating Joy
• Doing Right
• Improving Every Day
• Moving Forward
• Competitive Pay
• Free Mental Health & Life Coaching for Team Members and their Dependents
• Holiday Time Off with Pay
• Paid Community Service Day
• Paid Parental/Family Leave
• Generous Paid Time Off (PTO)
• 401k Retirement Plan with Company Match
• And much more....

What You’ll Do

Position Summary

The Specialist, Quality will work closely with our clinic staff to identify gaps in care, capture HEDIS documentation, perform chart audits, track patient engagement in care gap, and notify clinics of time sensitive care caps. They will also work with the Director of Quality to report low clinic engagement, opportunities for staff education, and reporting inaccuracies. Essential responsibilities consist of, but are not limited of the following:

Responsibilities

• Identify and notify clinical staff of next steps needed to address open quality gaps.
• Submit documentation to payer portal to close quality gaps.
• Audit supplemental data to ensure results are compliant for identified measures.
• Educate staff and providers on HEDIS technical specifications.
• Resolve clinical staff Quality inquiries.
• Join daily huddles as needed to inform clinical staff of patients with outstanding time sensitive measures.
• Collaborate with other departments on quality specific projects to help reach quality goals.
• Actively participate as a team player to promote positive health outcomes for our patients.
• Able to work Monday-Friday from 8-5PM MST and be in the DFW area.
• This is a 1099- Contract position.
• Be willing to take on additional task to support the overall success of the organization.

What You’ll Bring

Education Requirements

• Bachelor's degree in healthcare administration or public health required

Certifications Requirements

One of the following certifications, accompanied by 2+ years of experience in value-based care setting (primary care or Medicare Advantage Plans preferred):

• Certified Medical Assistant
• Certified Nursing Assistant
• NCQA certification

Experience Requirements

• 4+ years of experience in value-based care setting (primary care or Medicare Advantage Plans preferred)
• 2+ years of HEDIS or Risk Adjustment experience in supplemental data and chart reviews
• Knowledge of CMS STARS program
• Must have a basic understanding of billing and claims coding
• Experience reviewing Electronic Medical Records
• Intermediate level experience in working in Microsoft Excel, Word, and PowerPoint
• Experience navigating payer portals.
• At least 1 year of experience utilizing medical terminology.

Skill Requirements

• Ability to work independently
• Strong problem-solving skills with the ability to identify solutions independently and know when to appropriately elevate complex issues
• Ability to multi-task
• Ability to work in fast paced environments with changing priorities.

Suvida Healthcare provides equal employment opportunities to all Team Members and applicants for employment and prohibits discrimination and harassment of any type with regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.