Log In
Sign Up
Join us as a Quality Measure Specialist at AdventHealth and be part of a community focused on holistic care. Embrace career development and contribute to patient safety and care improvement. Valued for your unique experiences, contribute to the team’s success while making a positive impact. Apply today to thrive professionally and spiritually.
Summarize by CVGorilla
Quality Measure SpecialistAll the benefits and perks you need for you and your family:· Benefits from Day One· Paid Time Off from Day One· Career Development· Whole Person Wellbeing Resources· Mental Health Resources and SupportOur promise to you:Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.Schedule: M-F, FTShift : 8AM – 5PMLocation: Remote ( May require travel to provider offices and on site for meetings)The role you’ll contribute:The Quality Specialist performs a wide variety of tasks to be compliant with quality initiatives and otherrequirements to ensure patient safety and improved member care. This position will ensure the effective management ofcare gaps, including referral tracking and member/provider outreach. This position requires excellent communication,diplomacy, strong computer skills and the ability to manage complex working relationships.The value you’ll bring to the team:• •Maintains current expertise on quality measures (including but not limited to ACO, CMS, HEDIS etc)•Support and maintain outreach initiatives and other quality improvement strategies•Answers questions and provides clear instructions to enhance patient compliance and support quality metrics•Maintains and reviews medical records for purposes of identifying, confirming, and/or documenting referrals, results and appropriate medical coding•Collect and analyze data, needs assessments, cost and utilization data to support program planning and reporting requirements. Provide reports and/or information related to measures and provider performance•Designs, schedules and conducts quality review audits as appropriate to the healthcare practice or service; performs or coordinates chart and/or other medical record reviews and records and/or abstracts specific relevant data as appropriate.•Participates in the planning, development, coordination and presentation of specific training and educational programs as appropriate to the quality assurance needs of the health center or service.QualificationsThe expertise and experiences you’ll need to succeed:KNOWLEDGE AND EXPERIENCE PREFERRED :•Detailed technical understanding of industry standard Quality Measures including but not limited to HEDIS,and CMS quality performance standards•Experience working in health plan operations, Quality and/or IDNEDUCATION AND EXPERIENCE REQUIRED:Associate and 2 years experienceEDUCATION AND EXPERIENCE REQUIRED:•Bachelor’s Degree in health-related field or Business or Finance•Minimum of 2 years of experience working with Data and Data Analysis related to healthcareEDUCATION AND EXPERIENCE PREFERRED:•Registered Nurse candidate is preferred•Master’s Degree is preferred•Lean Sig Sigma green belt or PDSA training is preferredLICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:• Registered NurseThis facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.Category: Quality/Clinical EffectivenessOrganization: AdventHealth PHSO ResourcesSchedule: Full-timeShift: 1 – DayReq ID: 24018896We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
