Health Net · 7 hours ago
Quality Improvement Specialist PARS
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Responsibilities
Conducts on site PARS audits/reviews with individual PCPs, High Volume Specialists and Ancillary sites, and Hospitals and documents findings using the DHCS assessment tool according to DHCS MMCD Policy Letter 12-006 or current requirement.
Completes the PARS assessments; document results per Health Net Quality Improvement policies and procedures and regulatory requirements.
Manages visit audit schedules.
Uses data systems to record data, develops reports to be submitted to regulatory agencies, submit data for Health Net Web Portal and Provider Directory for PARS assessments, and develops outcome and trend reports for internal tracking.
Coordinates and conducts both individual and group in-services for PCPs, PPG’s, internal Health Net associates, and departments providing detailed instruction and assistance for implementation of mechanisms to meet DHCS requirements.
Provides technical assistance to PCPs, PPG’s, internal Health Net associates, and departments to improve accessibility for members.
Participates in PARS trainings and departmental/Health Net meetings, Heath Net compliance learning to maintain knowledge and skills.
Assists with departmental special projects, activities, and functions as requested by Manager.
Provides professional courtesy, customer friendly services to contracted practitioners and office staff.
Maintains confidentiality in compliance with HIPAA standards.
Performs other duties as assigned
Complies with all policies and standards
Qualification
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Required
Bachelor’s degree in health related field (Health Administration, Health Science, Epidemiology or Public Health etc.) or equivalent experience.
Previous communications or business experience in a health related environment.
One to two years experience in a provider or health care delivery setting.
Two to three years experience in a managed care environment coordinating programs/seminars for providers.
One to two years experience with computer applications and report writing.
Benefits
Competitive pay
Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
Health Net
Health Net provides health care coverage across California to over 3 million members, regardless of stage of life and socioeconomic status.
Funding
Current Stage
Public CompanyTotal Funding
unknown2016-03-24Acquired· by Centene
1991-06-21IPO· nyse:HNT
Recent News
2024-10-21
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