Quality Manager – STARS, HEDIS
Arkos Health
full-time
Posted on:
Location Type: Hybrid
Location: East Point • 🇺🇸 United States
Visit company websiteSalary
💰 $80,000 per year
Job Level
Mid-LevelSenior
About the role
- Provide oversight and direction to the STARS/HEDIS department.
- Hold staff accountable to Departmental goals.
- Schedule and follow up on clinical care needs for patients as it relates to Quality Data.
- Manage staff in the STARS/HEDIS Department and assist staff in quality initiatives.
- Collect, report, and respond to metrics.
- Contribute to the organization's drive to improve the overall experience of patient care.
- Review and provide performance feedback to the STARS/HEDIS department.
- Establish annual and monthly departmental and individual staff goals.
- Ensure the training and on-boarding of new staff.
- Perform quarterly performance reviews for all Arkos Health STARS/HEDIS staff.
- Provide education regarding STARS/HEDIS initiatives to staff and outside individuals.
- Attend Arkos Health educational and demonstration activities.
- Review data collected and develop strategies to improve performance.
- Implement strategies to improve department performance.
- Create, maintain, and improve written department process flows and procedures.
- Ensure gaps in care are captured.
- Coordinate and order preventative and diagnostic tests around gaps in care on behalf of the primary care physician.
- Conduct data entry and maintain appropriate documentation and tracking for quality initiatives.
- Educate patients on procedures being performed.
- Collaborate with the PCP in the management and care coordination for members with open gaps of care.
- Demonstrate the ability to work collaboratively as a high performing quality team member.
- Coordinate and participate in internal and external meetings.
- Contribute as an active participant in quality initiatives.
- Follow Arkos Health procedures, practices, policies, and guidelines to ensure the safety, security, and well-being of patients.
Requirements
- Medical Assistant Diploma and/or Certified Nurse Assistant Certification
- 1+ years’ experience as a manager.
- 2+ years' experience in a healthcare environment
- Recent and related experience working with HEDIS STARS Program
- Experience in Electronic Health Records
- Experience with verifying eligibility and navigating through Insurance Portals
- Experience with CPT II codes
- Basic knowledge HCC’s and Medical Diagnosis
- Ability to perform multiply procedures with training (i.e.) ABI, DRE, Urine Dips
- Familiarity of Medicare guidelines to perform patient screening’s
- Knowledge of medical terminology
- Current unrestricted state driver’s license with personal reliable transportation
- Proof of liability insurance coverage
- Excellent leadership, management, and communication skills with ability to work collaboratively with other departments and external stakeholders; must be fluent in both spoken and written English and maintain professionalism in all verbal and written correspondence with both internal and external clients.
- Strong ability to self-manage time to manage multiple projects and priorities in a fast-paced environment
- Able to utilize necessary programs to ensure effective communication, collection of metrics, and proprietary software; including but not limited to: Microsoft product suite, Adobe Suite
- Strong analytical and problem-solving skills.
Benefits
- Employer-paid Medical premiums at no cost to you
- Employer-paid Dental premiums at no cost to you
- Employer-paid Vision premiums at no cost to you
- Employer-paid Short-Term Disability premiums at no cost to you
- Employer-paid Life Insurance premiums at no cost to you
- Employer matching 401(k)
- 15 days annual combined sick/vacation during your first year
- 10 paid holidays
- Your Birthday off!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
HEDIS STARS ProgramElectronic Health RecordsCPT II codesHCC'sMedical DiagnosisABI proceduresDRE proceduresUrine Dips proceduresMedical terminology
Soft skills
leadershipmanagementcommunicationcollaborationtime managementanalytical skillsproblem-solving
Certifications
Medical Assistant DiplomaCertified Nurse Assistant Certification