About the job
Remote Opportunity
Preferred Candidate Locations:
We highly encourage applicants based in the following states to apply: Texas (TX), New York (NY), New Jersey (NJ), Florida (FL), and Pennsylvania (PA).
PRIMARY FUNCTION
Primary functions are maintaining our contracted HEDIS performance, supervision of Patient Outreach Coordinator activities and assisting with administration needs associated with maintaining AAAHC accreditation.
ESSENTIAL DUTIES AND RESPONSIBILITIES
This list may not include all the duties that may be assigned.
- Track and monitor HEDIS performance for the organization as per contracted performance by plan.
- Utilize HEDIS tracking sheets to direct outreach teams as needed to maintain needed performance metrics.
- Oversee the administrative aspects of accreditations.
- Input and track accreditation information and task requirements.
- Prepare and submit periodic reporting required by the accrediting agency to maintain status.
- Communicate performance trends and documentation issues to the quality team for quality improvement actions.
- Hires, trains, coaches, counsels, and evaluates the performance of direct reports.
- Completes annual employee evaluations, manages new hires and staff development.
- Monitor and evaluate outreach teams’ performance, to include, but not limited to, all performance evaluations, call volume, and provide coaching opportunities and corrective actions when needed.
- Responsible for the supervision of training and development of new and existing patient outreach coordinators by assisting with new-hire training classes and conducting refresher training.
- Collaborate with external payers in the submission of supplemental data files and quality performance meetings.
- Perform various duties as assigned.
SUPERVISORY RESPONSIBILITIES
Train and direct 6 patient outreach coordinators.
QUALIFICATIONS
EDUCATION:
- Bachelors in healthcare administration, nursing, or other healthcare-related field, master’s preferred.
EXPERIENCE:
- 5 years of healthcare experience required.
- Experience supervising and managing direct reports preferred.
- Experience with clinical quality metrics/HEDIS preferred.
LICENSURE / CERTIFICATION: None
KNOWLEDGE, SKILLS, AND ABILITIES
- Strong communication skills
- Strong clinical, interpersonal, organizational and communication skills
- Strong English writing skills with excellent spelling, grammar, and punctuation.
- Ability to manipulate data and create presentations.
- Excel, PowerPoint, Outlook, and Word are consistent with basic Microsoft Office certification.
- Willing to learn the quality process as it relates to medical practice.
- Requires strong computer skills and experience with electronic health records.
- Ability to work independently and as a team player.
- Detail-oriented, ability to multitask
- Positive attitude and display exceptional customer service skills.
- Strong telephonic skills and verbal articulation skills
- Ability to assess emergency situations and act accordingly.
- Effective working relationships with patients, parents, guardians, co-workers, and the public
TYPICAL WORKING CONDITIONS
- Non-patient facing
- Potential involvement with patients when issues are escalated to the manager.
- Full-time remote; must be U.S. based.
- Indoor work
- Operates a computer.
- May be exposed to hazards.
- Travels to business and medical offices to assist with accreditation processes.
Pediatric Associates Family of Companies is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.