Quality Assurance Specialist
3 weeks ago
Responsibilities:
* Utilize EPIC, Azara, UDS, ODM, HRSA, and other databases to identify and formulate data relating to patient needs and clinical programs.
* Manage all aspects of credentialing, re-credentialing, and contract enrollment for providers.
* Maintain up-to-date data for each provider in credentialing databases and ensure timely renewal of licenses and certifications.
* Manage patient data and generate reports for analysis to identify quality-of-care gaps and opportunities.
* Work with the QA Director to identify and report outlying metrics to review with the leadership team.
* Review payor program metrics and formulate data required to meet CAHC quality initiatives and participate in monitoring improvement initiatives.
* Monitor payor care management program targets and ensure we are on track through monthly monitoring and reporting.
* Work collaboratively with the Director of Quality and Risk Management to implement quality initiatives, including population health initiatives.
* Monitor, review, and capture quality initiatives and gaps, and work with the Finance department to identify payor incentives.
* Maintain a quality dashboard for tracking and reporting purposes.
* Create reports and metrics data for all CAHC departments.
Requirements:
* Bachelor's degree in Public Health, Epidemiology, Nursing, or a related field.
* Minimum 3 years of experience developing and implementing healthcare quality initiatives and data management.
* Minimum of 3 years of experience generating quality reports, analyzing data, and reviewing clinical workflows.
* Must be proficient in managing insurance payor programs.
* Proficient in data abstraction and following metric trends.
* Strong attention to detail and ability to prioritize and multitask.
Compensation details: Yearly Salary
We offer a competitive salary and a dynamic work environment. If you are a motivated and detail-oriented individual with a passion for quality improvement, we encourage you to apply for this exciting opportunity.
Please submit your application, including your resume and a cover letter, to [insert contact information].
We look forward to hearing from you
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