QUALITY DATA SERVICE COORDINATOR at Southern New England Healthcare

Windsor, Connecticut, United States -

Full Time

Start Date

Immediate

Expiry Date

11 May, 26

Salary

0.0

Posted On

10 Feb, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Quality Improvement, Population Health Management, Data Reporting, HEDIS, STAR Measures, Communication Skills, Organizational Skills, Problem Solving, EMR Systems, Patient Care, Collaboration, Educational Presentations, Microsoft Office, Project Management, Confidentiality, Value-Based Care

Industry

Hospitals and Health Care

Description

SUMMARY OF RESPONSIBILITY: The SoNE HEALTH Quality Data Service Coordinator works in concert with SoNE HEALTH physicians and their staff, acting as an educator and resource, to assist, guide and support them through their participation in payor-driven financial incentive HEDIS review programs for Commercial, Medicare and Medicare Advantage carriers. Strong organizational skills and attention to detail is essential. Facilitates the identification of patients lacking early detection and regular preventative screenings, assisting providers to better manage chronic illness utilizing tools and reports from payors and in-house resources. Performs on-site or in-field chart review and abstractions of pertinent documentation that supports the physician’s clinical effort to complete all appropriate assessments and quality testing for patients. Collaborates closely with payors, providers and patients, in order to promote the completion of required screenings and assessments resolving barriers to compliance. Educates providers and staff on national quality metrics, such as HEDIS and STAR measures, and recommends and assists with strategies to enhance performance levels. Creates and preforms presentations. May assist practices with performing outreaches to patients with scheduling appointments with for Annual Wellness Visits. Promotes a positive, professional, cooperative working environment and population health management team approach. This role is located at the company's headquarters in Windsor, CT, and operates in hybrid/remote environment. ESSENTIAL FUNCTIONS: * Facilitates the identification of patients lacking early detection, regular prevention screening and managing chronic illness. * Utilizes the payor and in-house resources reports, that identify potential patient gaps in care and goals for achieving maximum performance. * Reviews and abstracts pertinent documentation to support the clinical physician efforts to complete all appropriate screening and tests for patients. * Interprets and reviews medical data in various EMR systems. * Collaborate with physicians and practice staff on the findings of the review and steps needed to fulfill the required screening/testing. * Educates providers on various national quality benchmarks such as HEDIS and STAR measures. * Develops written materials encompassing HEDIS Star Quality metrics as described by NCQA * Presents educational and marketing material to provider groups during events sponsored by SoNE HEALTH. * Creates and performs presentations at various in-person and/or virtual meetings * Problem solves barriers to exceptional performance by formulating action plans to assist physician groups to close gaps in case. * Reviews office work flows, shares Best Practices with the providers and office staff * Enhances the understanding of integrated care coordination through SoNE. * Recognizes each patients’ rights by providing confidentiality of patient information according to established policy and accepted professional standards. * Serves as a liaison and resource for the physician, payor, and healthcare team to facilitate appropriate quality standard-based care. * Collaborates effectively and efficiently with all internal and external stakeholders i.e. physicians and their office staff, payors to maximize opportunities to improve outcomes for all of our patients. * Seeks educational opportunities for on-going professional development with an emphasis in Stars/HEDIS Quality Improvement and other Process Improvement Methodologies. * Has a solid understanding of value-based care models. * Promotes a professional image with all interactions and functions. Other Functions: * Performs other duties as assigned. The duties listed above are intended only as illustrative of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar or a logical assignment to the position. QUALIFICATIONS AND COMPETENCIES: * BA/BS in Business Administration or Healthcare Administration or equivalent experience * Medical Assistant/LPN Certification or equivalent preferred * 3+ years of healthcare related experience with HEDIS and Stars, CAHPs and HOS * 3+ years of experience in quality improvement and/or population health management * 5+ years of experience utilizing Excel and other data reporting tools * 3+ years within a data driven, healthcare environment and/or healthcare-related field. * Athena experience preferred along with other EHR/EMR platform experience. * Knowledge of quality improvement processes, data collection, Microsoft Office with an emphasis on spreadsheets, and project management tools and outcome analysis preferred. * This position requires highly developed communication and interpersonal skills, self-direction and problem-solving skills. * Excellent organizational and interpersonal skills required, with the ability to communicate and work collaboratively with all levels of SoNE staff, payors, providers and office staff, and effectively utilizing all resources available. * Must be adaptable to unpredictable situations in a patient care setting while effectively managing assigned duties with precise attention-to-detail, accuracy and excellent follow-up and follow-through, with minimal supervision. * Maintains strict confidentiality with patient information in a professional manner. * Current and valid Driver’s License. * Previous telecommuting experience. PHYSICAL AND MENTAL REQUIREMENTS: The Physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to work long hours – over eight in a work day, and over 40 in a work week as necessary; * Regularly required to use hands to finger, handle or feel objects, tools, or controls; reach with hands and arms; and talk or hear. * Frequently is required to walk and sit. * Occasionally required to stand; climb or balance; and stoop, kneel, crouch or crawl. * Ability to lift and/or move up to 20 pounds. * Vision abilities required by this job include close vision, color vision, peripheral vision, depth perception and ability to adjust focus. * The dexterity necessary to utilize a computer keyboard on a regular basis is essential. ADDITIONAL REQUIREMENTS: * As a condition of employment at SoNE HEALTH, all employees must reside in New Hampshire, Rhode Island, Maine, Vermont, Connecticut, or Massachusetts. * For the safety and well-being of our employees, all employees are required to be fully vaccinated for influenza. * If you will be working in a remote or hybrid capacity, we require a stable internet connection. We recommend that you have an internet service provider with speeds of at least 30Mbps download/5Mbps upload. ADHERENCE TO THE SoNE HEALTH CODE OF CONDUCT: * Code of Conduct: Employee will understand and follow the guidelines and standards outlined in the SoNE HEALTH Code of Conduct and demonstrate an understanding of the SoNE HEALTH Mission, Vision and Core Values. * Policies and Procedures: Employee will comply with all SoNE HEALTH policies and procedures relevant to their role, including those related to compliance, safety and confidentiality. * Regulatory Requirements: Employee will ensure actions and behaviors are in accordance with applicable laws, regulations, professional standards, policies, procedures and the Code of Conduct. SoNE HEALTH BENEFITS: We offer a competitive compensation package, which includes a comprehensive benefits program that begins on the first of the month following date of hire. Our benefits include: * Medical, dental, and vision insurance * 401(k) retirement plan with employer match * Short-Term Disability Insurance * Long-Term Disability Insurance * Basic Life & Accident Insurance * Flexible Spending Accounts * Voluntary Benefits * Homeowners Insurance * Auto Insurance * Critical Illness Insurance * Pet Discount Plans * Earned time off, sick time, company holidays and one floating holiday * Paid Volunteer Time * Employee Assistance Program * Educational Assistance (Tuition Reimbursement) after one year of employment * Employee Discount Program for discounts on entertainment, travel, and shopping

Responsibilities

The Quality Data Service Coordinator facilitates patient identification for screenings and chronic illness management while collaborating with providers and payors. They also educate staff on quality metrics and assist in closing care gaps.