Company Statement

Careers at AdvantageCare Physicians: At AdvantageCare Physicians, our providers and care teams reflect our commitment to population health. Improving the health of our patients is our goal; keeping our patients healthy is our commitment. Using our state-of-the-art electronic medical record (EMR) system, our providers, care teams, and practice administration staff work together to deliver high-quality, comprehensive and convenient care to our patients.

Lead Quality Specialist

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Patient Services
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2005C Requisition #
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AdvantageCare Physicians is the largest physician led outpatient medical office in the New York Metropolitan Area. With 36 medical offices in the Brooklyn, Long Island, Manhattan, Queens and Staten Island, we aspire to be the preferred care destination for our patients and the communities we serve. This vision is accomplished through focusing our care on the needs of our patients as we partner with them in the pursuit of better health.  Each and every day, our actions should be guided by these principles as we interact with our patients, each other and our communities. The values that drive the AdvantageCare Physicians culture include a caring attitude, quality focus, collaboration, excellence and good citizenship. By integrating these behaviors into our day-to-day operations, we can deliver the highest quality healthcare while also creating positive patient experiences.

 

Responsibilities:

  •    Provides outreach to patients to support Healthcare Effectiveness Data and Information Set (HEDIS),  Hierarchical Conditions Category (HCC), and other quality improvement activities as well as support  on related projects.

  •    Supports and guides the Quality Specialist team in maintaining set quality processes and procedures including productivity reporting, validation of outreach documentation & workflows in EPIC. 

  •    Supports additional activities aimed at improving HEDIS, HCC, and other quality and care coordination activities, including but not limited to identifying information in medical records and providing information to providers and other staff members including reporting support to identify outliers and or training needs. 

  •    Provides support and guidance to the team during the implementation of new projects, changes in workflow, and changes in regulations that govern the HEDIS, HCC and Clinical Risk Group(CRG) initiatives. 

  • Provides patient outreach to schedule appointments, including determining what barriers or obstacles exist that prohibit the patient from making or keeping appointments. 

  • Within guidelines, determines what resources may be needed or action should be taken to enable the patient to keep appointments.

  • Reviews patient’s charts as needed to determine compliance based on specification or process outlined. Determines next steps based on chart review findings.

  • Maintains full understanding and application of HEDIS/HCC specification and/or policy as it relates to compliance determination and outreach for execution of and support to staff at introduction of new initiatives.

  • Coordinates quality related projects.

  • Assists in shadowing staff to assess training needs. 

  • Provides support to staff on introduction of new projects or changes in processes.

  • Determines possible root cause of issues effecting patient compliance and presents issues and possible solutions to management.

  • Conducts work essential to supporting outreach efforts, including but not limited to:

  • Collecting and verifying compliance data

  • Entering data

  • Summarizing findings

  • Recording the results of outreach

  • Reporting results to management

  • Presents information and coordinate activities within medical offices.

  • Assists in educating providers and other staff on quality related activities (e.g. HEDIS, HCC)


Qualifications:

  • High School Diploma

  • Bachelor’s Degree

  • Minimum of three years’ experience in health care setting including experience with HEDIS quality measures and HCC.

  • Minimum of two years’ experience in quality related activities. 

  • Knowledge of utilizing electronic medical records systems (such as EPIC).

  • Computer proficiency, with proficiency in the use of Microsoft Word, Excel, and PowerPoint.

  • Strong interpersonal, communication, organization and writing skills with the ability to effectively prioritize work.

  • Commitment to enhancing member experience.

  • Ability to work at least one evening per week

  • Experience with Patient Centered Medical Home (PCMH).


EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

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