WorkatHome-JobBoard · 6 hours ago

QUALITY COORDINATOR/RN

Sparks, NV

Part-time

Remote

Mid, Senior Level

5+ years exp

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Responsibilities

Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies Optimize AWV completion and promote as an opportunity for completing HCC capture Leadership of RN Care Managers and Population Health Coordinators within a collaborative environment, to maximize longitudinal care of the patients.

STARS/HEDIS and MIPS Performance

Participate in the development of an annual work plan for improvement of STAR ratings, HEDIS and MIPS capture/performance from the position of the leader of the market quality team.

Support system efforts that may include MSO initiatives, new payer contracts, and risk initiatives.

Help create and support quality-based clinic workflows geared towards capturing gaps in care (chart scrubbing, pre-charting, huddles, Patient Care Conferences (PCCs)

Support provider reviews of performance on a regular cadence (monthly preferable).

Participate in payer meetings, create appropriate JOCs with payers.

Optimizing HCC capture and appropriately maximizing RAF

Education of clinical staff concerning HCC capture and importance of RAF

Develop and implement strategies for maximization of attestation form completion.

Longitudinal Care Coordination

Provide leadership of quality team in the ongoing development of quality and timely patient care across the care continuum

Develop collaborative relationships across the patient care spectrum in the pursuit of warm patient hand-offs and a seamless care experience.

Qualification

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Registered Nurse LicensePopulation Health ExperienceQuality Improvement InitiativesHEDIS/STARS/MIPS Experience

Required

Graduation from an accredited nursing education program.

Actively licensed by the worked in State to practice as a Registered Nurse.

Minimum of 5 years of associated Population Health/Quality experience within the health care industry, preferably ambulatory based and includes experience with HEDIS/STARS and MIPS

Bachelor's Degree