Health Net · 7 hours ago

Quality Improvement Specialist (PARS)

Los Angeles, CA

Full-time

Remote

Entry, Mid Level

$25.97/hr - $46.68/hr

2+ years exp

Maximize your interview chances

Financial ServicesHealth Care

Insider Connection @Health Net

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

PARS auditsHealth AdministrationHealth ScienceEpidemiologyPublic HealthManaged care experienceComputer applicationsReport writingTechnical assistanceConfidentiality (HIPAA)Program coordination