Quality Specialist

Insider Connection @EPIC Health - Exclusive Physicians | Integrated & Comprehensive

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Responsibilities

• Provides expertise in analysis of data related to supporting value-based programs. Skills include accessing internal databases and tables as well as utilizing Excel skills
• Participates in meetings with vendors for the medical record collection process. Assists Manager with medical record vendor oversight
• Participates in projects to ensure the strategic directives of the stakeholders are executed and time sensitive deadlines met
• Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidence, documentation, and changes
• Monitor, evaluate and report on program status inclusive of scope, schedule, budget and alignment to program and strategic goals
• Direct corrective action, as needed, to maintain the viability of value-based reimbursement Programs
• Provide training and education to staff related to the data available, how to access it, and what metrics might be of interest

Benefits

• Opportunities for professional and personal growth
• Excellent Health Insurance through Blue Care Network with a VIP policy to provide you with affordable access to the best care.
• Premium Dental and Vision coverage
• Buy Up Option for Short- and Long-Term Disability, and Life & AD&D Insurance
• 401(k) investment opportunities
• Generous Holiday, Vacation and Personal time
• Work/Life Balance
• Employee Recognition and Assistance Programs
• Welcome to EPIC Primary Care, a medical network dedicated to providing patients with the best possible medical care.
• Ferndale, Michigan, USA
• https://www.epichs.org
• Growth Stage
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Qualifications

• Bachelor's Degree in related field and two (2) years' experience in the health industry. An equivalent combination of education and experience may be substituted to meet this requirement
• HEDIS/Gaps in Care Experience
• Knowledge of payers and their requirements for each measure
• Knowledge of Patient Centered Medical Homes and Accountable Care Organizations
• Microsoft Office Skills
• The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers
• Bachelor’s Degree in related field and two (2) years’ experience in the health industry. An equivalent combination of education and experience may be substituted to meet this requirement.

Required skills

• Accountable Care Organizations, Gaps in Care, HEDIS, Patient-Centered Medical Homes

Experience

• 2+ years