SUMMARY: Support the Ambulatory Quality Department in the ongoing management and performance improvement of Payor Quality programs, including CMS Accountable Care Organization Performance Measures. This individual will be responsible for becoming an expert in priority metrics and working closely with payors and internal leadership to identify areas of opportunity and assist in performance improvement.

Job Duties & Essential Functions:

• Analyze available payor summary and patient-level data to identify opportunities for gap closure.
• Identify data quality and integrity opportunities through QA of internal and external datasets
• Assist in the development and distribution of departmental and provider summary data and gaps in care reports
• Work with analytic staff to develop effective and actionable reporting
• Provide guidance to Ambulatory Departments and Leadership to assist in understanding and interpreting information in reports.
• Maintain up-to-date knowledge and understanding of Managed Care and ACO program measure specifications and compliance requirements
• Facilitate annual CMS reporting to meet ACO requirements
• Provide support in the design, development and maintenance of quality improvement initiatives
• Review and summarize annual CMS program changes and work with CIN Leadership, IT, EMR Vendors and Departmental Staff to implement
• Perform medical record chart review in order to obtain documentation of measure compliance.
• Perform gap closure by direct outreach to patients, which may include appointment scheduling.

Required Education and Qualifications:

• Bachelor’s degree in healthcare, analytics or related field. In lieu of Bachelor’s degree, 4 years of relevant experience.
• 2 years of relevant experience.
• Experience in healthcare Quality.
• Experience in data analytics.

Preferred Education and Qualifications:

• Three or more years of relevant experience in quality measures, quality improvement and payor incentive programs.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is active and requires the employee to constantly move about in the office to assist patients, staff and medical providers. Any additional physical demands will be outlined and provided by management.

The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of CPMP.

CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.

CPMP expressly prohibits any form of workplace harassment based on race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected status. Improper interference with the ability of CPMP’s employees to perform their job duties may result in discipline up to and including discharge.

Job Type: Full-time

Benefits:

• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Associate (Required)

Experience:

• HEDIS: 1 year (Preferred)
• accountable care: 1 year (Required)

Work Location: One location

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