Job Type

Full-time

Description

Job Summary

The Medicare Advantage Quality Coordinator supports assigned practices in activities to improve quality and Star Rating performance for Medicare Advantage programs.

• Serve as subject matter expert on Medicare Advantage incentive programs/Star Ratings requirements and objectives.
• Participate with Director of Quality in joint operations committee meetings and ongoing meetings with Medicare Advantage payers.
• Using data from payer portals, reports, and meetings, monitor and evaluate practice progress on meeting quality measures, Star Rating improvements, suspect medical condition assessments, care gap closure, annual care visits, patient experience measures, etc.
• Use payer data to identify and prioritize patients who need to be scheduled for a visit.
• Coordinate with practices to complete assessments, schedule visits, and close care gaps.
• As appropriate, contact patients to encourage and coordinate scheduling of visits and closure of gaps.
• Complete all assessments and attestations in payer portals for assigned practices.
• Collaborate with Clinical Quality Managers and Quality Analyst to address opportunities for improvement and for assistance in engaging with practices.
• Collaborate with Patient Experience of Care Manager to address opportunities for improvement in patient experience measures.
• Consider creative and innovative methods of patient outreach to increase patient compliance.
• Participate in collaborative efforts to reduce hospital readmissions and unnecessary Emergency Department utilization.

Requirements

Minimum Qualifications

• Current LPN license preferred
• Previous experience in patient care and/or care coordination role.
• Critical thinking skills and ability to analyze data.
• Excellent interpersonal and communication skills.
• Strong self-motivation