Job Description

Location: Steward Medical Group - Central
Posted Date: 4/9/2021

POSITION SUMMARY:

Reporting to the Operations manager. Utilize reporting and established metrics to insure our market is compliant with contractual requirements and medical management initiatives. Interact with physicians, office staff and patients to insure proper quality reporting/ compliance is completed. Utilize our EMR to translate data into actionable items, track and follow up on stated quality goals. Reports weekly on findings, progress, areas needing process improvement and compliance. Assists with duties as assigned.

KEY RESPONSIBILITIES:

  • Collaborates with quality team members and analytic staff to develop comprehensive, timely, valid reports and presentations on clinical care quality, health and risk status, patient experience and care management opportunities within the SHCN patient populations;
  • Mange the reporting processes SHCN to meet contractual obligation to commercial and government payers related to quality performance.
  • Support quality improvement activities that influence Pay for Performance, Referral Management, Provider Profiling, Variation, and Population Management with data, reporting, and analysis;
  • *  Address ad hoc analytic requests of Provider Organizations, Medical Directors, Steward Medical Group, and SHCN leadership while effectively managing team resources;
  • Manages and disseminates information on providers in the SHCN network. Work collaboratively with IT and others to assure the accuracy, validity, and consistency of all sources of provider data;
  • Assures data quality and accuracy through implementation of effective audit and data management practices;
  • Support efforts to select and implement optimal analytic software in support of SHCN data analysis and data management;
  • Develops and utilizes appropriate project tracking systems and processes to manage the supply and demand of analytic resources;
  • Assist with charge entry at end of each month
  • Provides excellent communication with all customers, interacting with Medical Directors, Corporate IT staff and management, SHCN staff and leadership, payers and other external constituents while meeting their information and reporting needs.

REQUIRED KNOWLEDGE & SKILLS:

  • Possess strong analytic skills and the ability to translate complicated data into useable information, including analysis of practice variation;
  • Work related knowledge of clinical measurement concepts and HEDIS-like assessments of patient populations;
  • Excellent verbal and written communication skills; outstanding interpersonal skills; Ability to relate positively with individuals at all levels of the organization;
  • A history of creativity and flexibility as a self-motivated professional with sound judgment.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  1. Education: High School Diploma or equivalent.
  2. Experience: 1-2 years in Healthcare, Strong verbal and written communication skills, Knowledge of coding and billing a plus.
  3. Certification/Licensure: N/A
  4. Software/Hardware: MS Office, PowerPoint, Prefer knowledge of registries and risk stratification tools.

Application Instructions

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