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ACO Quality Support Specialist (North Fort Myers)

Job Description/Requirements:
The ACO Quality Support Specialist is responsible to assist the department in ongoing HEDIS collection and Quality Improvement Activities. The position reports to the Director of Quality Programs. This position includes ongoing quality improvement activities to assure the organization's quality programs are implemented and meet all requirements for successful HEDIS and quality metric reporting to ACO clients.
Job Standards:
Assists quality team in performing chart reviews for scheduled visits re contracted quality metrics and GPRO reporting. Support continuum of patient care by identifying patients with gaps in care or in need of quality metrics reporting prior to scheduled identified visits.
Provides feedback to manager of areas of opportunity for HEDIS/Quality Measures and other contract-mandated quality metrics specification and pay for performance measurements, and medical record review criteria for GPRO.
Supports the reporting of HEDIS/Quality metrics chart review and/or creation of quality scrub encounter/alert.
Works independently under the supervision of a Quality Assurance Manager and cohesively with Quality Team.
Travel to providers office for data collection (also offsite chart retrieval).
Assist clinical teams with proper documentation/requirements for quality requirements
Analyze quality measures and identify opportunity trends for better patient health outcomes.
Supports Quality team in preparation of coding summary spreadsheets, communications and follow up with providers, schedules reviews and builds rules in EHR to capture.
Ability to use multiple insurance and quality data bases to support successful Care Gap closure for patients.
Assist department with claims work lists related to coding and quality initiatives.
Exhibits strength in verbal and written communication and prioritization of assignments.
Recognizes the confidentiality of the work assignments and department assignment.
Assist with ongoing GPRO data submission.
25-50% travel requirement.
Remote position 90% of the time, 10% of position will be spent at the North Fort Myers office.



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