Quality Reporting Specialist

The Quality Reporting Specialist plays a critical role ensuring practice and ACO success in our Medicare Advantage and commercial contracts with a focus on HEDIS quality measures. The Specialist must be service-oriented, well-versed in HEDIS quality measures, and familiar with approaches for reviewing ambulatory care charts both electronic (EHRs) and paper to identify and submit documentation to address quality measure gap closure. This role requires strong attention to detail, great communication skills (both oral and written), and a passion for quality measure performance. 

1. Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient 

2. Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with field team to assist guiding practices through gap closures 

3. Submit documentation to health plans and employ optimal method in each practice (i.e., upload to payor portal, secure email, etc)

4. Coordinates Electronic Health Record (EHR) system access set-up & login management

5. Consult with market field team members on quality reporting strategy - providing relevant market updates and chart review feedback for assigned practices

1+ years experience in quality reporting in healthcare or health plan setting

Experience working within at least one (1) major Electronic Health Record system (athenaHealth, eCW, etc) 

Comfortable exporting data, formatting and reporting out results (Excel or Google Sheets experience) 

Able to work independently and prioritize deadlines 

Track and communicate progress; escalate barriers to performance 

Strong written and verbal communication skills 

Strong attention to detail

Bachelor’s degree is preferred or equivalent work experience

G-Suite Proficiency

Experience working with the Medicare Advantage STARS program and HEDIS measures

Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.

Aledade PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

 

At Aledade PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

 

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

 

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners

Robust time-off plan (21 days of PTO in your first year)

Two paid volunteer days and 11 paid holidays

12 weeks paid parental leave for all new parents

Six weeks paid sabbatical after six years of service

Educational Assistant Program and Clinical Employee Reimbursement Program

401(k) with up to 4% match

Stock options

And much more!