• Quality Improvement Analyst

    ConnextCare (Pulaski, NY)


    Quality Improvement Analyst

     

    Pulaski, NY (http://maps.google.com/maps?q=61+Delano+St.+Pulaski+NY+USA+13142)

    Description

    Basic Function:

    To identify areas for improvement regarding patient care quality by analyzing data, conducting audits, and identifying trends. Proposing and implementing solutions to enhance quality and efficiency, often collaborating with cross-functional teams to drive continuous improvement.

    Principal Accountabilities:

    + Review Gaps in Care for Quality Incentive initiatives through payor contracts, Independent Provider Association (IPA) contracts, Accountable Care Organization (ACO) contracts, and Social Care Networks Contracts

    + Complete/Coordinate system wide HEDIS Insurance chart audits

    + Review Gaps in Care and follow up for all identified HEDIS audits

    + Coordinates Patient Centered Medical Home roster updates with Credentialing Specialist and Billing Manager to ensure accurate updates

    + Review Gaps in Care for Quality Measures from internal audits

    + Patient outreach as required by contracts or as requested by Supervisor

    + Complete Value Based Payments (VBP) and other alternative payment metric evaluations and follow-up as requested by management as well as insurance companies (payors) by performing chart audits

    + Assist with the development and implementation of population health programs and assist with tracking outcomes

    + Generate reports on population health metrics and outcomes

    + Assists with development of survey instruments and assessments for primary data collection

    + Assist other departments with pending/open referrals and open order reports as requested by Supervisor

    + Completes unmatched lab reports

    + Monitor and support other data collection opportunities as requested

    + Assist with and promote all processes associated with the Coleman initiative

    + Promoting Patient Centered Medical Home (PCMH) initiatives

    + Other duties and responsibilities as requested by supervisor and/or management

    Requirements

    Knowledge/ Education Requirements:

    A. High school graduate or GED, associate degree preferred

    B. Prior population health or ambulatory care experience preferred

    C. Verbal and written communication skills, medical office applications preferred

    D. Demonstrate proper judgment and decision-making skills

    E. Must demonstrate computer proficiency with electronic medical record system

    Salary Description

    $17.00-$21.00 Depending on Experience