HEDIS/STARs Specialist
1 week ago
We are seeking a highly skilled HEDIS/STARs Specialist to join our Quality Management team at MedPOINT Management. As a key member of our team, you will play a crucial role in assisting providers and their staff in performance programs, including HEDIS and STARs measures.
Key Responsibilities- Develop and implement effective education programs for providers and their staff on HEDIS and STARs measures.
- Recommend workflow efficiencies to providers and their staff to improve HEDIS scores.
- Train providers and staff on health plan P4P incentive programs, track progress, and make recommendations for success.
- Identify member service gaps and review reports with providers and their staff.
- Collect medical records and reports from provider offices based on open member care gaps.
- Collaborate with other MedPOINT HEDIS/STARs specialists and health plan staff to monitor gap closures and improvement activities.
- Participate in scheduled meetings with the MedPOINT QM Specialist team and health plan JOMs.
- Handle incoming calls from providers and provider staff to answer questions regarding quality metrics.
- Coordinate quality initiative projects for various groups and perform follow-up and outcome determination.
- Train offices in enterprise-wide HEDIS software program (Cozeva) and track usage.
- Assist with member outreach efforts as directed.
- Submit actionable work plans to health plans and track progress.
- Supplemental data submission and tracking.
- Participate in supplemental data overreading as needed.
- Create and present provider training materials to individuals as well as in small and large group settings.
- Additional QM tasks as directed.
- High school graduate or GED equivalent.
- Minimum of four years' experience working in a quality department in a health plan or IPA HEDIS environment.
- Working knowledge of NCQA HEDIS technical specifications.
- Current CA driver's license.
- Willing to travel to provider offices throughout Los Angeles.
- Effective verbal and written communication skills.
- Excellent interpersonal skills.
- Ability to multitask in a busy department.
- Innovative critical thinker.
- Ability to work independently and productively in a remote setting.
- Able to manipulate and analyze large files and data sets.
- Excellent project management and organizational skills.
- Intermediate to advanced skills with Microsoft Office Products (particularly with Word and Excel).
- EZ-CAP knowledge a plus.
We offer a dynamic and supportive work environment, competitive compensation, and opportunities for professional growth and development. 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 note that only qualified candidates will be contacted for an interview. We are an equal opportunity employer and welcome applications from diverse candidates.
Thank you for considering this opportunity to join our team at MedPOINT Management.
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