QI Data Coordinator - HYBRID (75% Travel)

Company Description

WHO IS GUIDEHEALTH? 

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. 

This position is Hybrid and will require travel to client locations ( up to 75% max). We are only accepting applications for local candidates who reside or plan to reside within a 90 minute drive of Metro- New Orleans area. We thank you for your understanding. 

Job Description

REMOTE with Travel 

As outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs. 

WHAT YOU’LL BE DOING 

• Work in a partial remote environment and virtually engage with company and team in your daily work. 

• Travel to provider offices as needed to support patient care and quality improvement efforts including but not limited to perform eye exams at provider offices for which training will be provided and scan and manage patient medical records. 

• Subject Matter Expert (SME) on entire scope of QI measures, services, customers and quality initiatives under various commercial and governmental payers. 

• Conduct proactive patient outreach initiatives to identify and address quality gaps, engaging with patients to educate them on preventive care measures, schedule necessary screenings or appointments and facilitate adherence to treatment plans, thereby contributing to improved health outcomes and closing quality gaps 

• Collect quality data using various methods of data sourcing-EMR, claims, provider outreach. 

• Manage daily work using multiple systems and applications-EMR systems, payer portals, vendor platforms, Guidehealth applications, Microsoft 365 for Excel, Word and PowerPoint and Teams for messaging and meetings. 

• Work with patient lists, gap lists, sourced health data and medical records in your daily work. 

• Leverage all quality related resources to ensure accuracy and completeness of work-measure/project instructions, NCQA/HEDIS® specifications, coding documents, quick reference guides. 

• Prioritize daily work to meet various quality reporting deadlines and requirements. 

• Communicate quality performances, barriers and improvement strategies both internally and with customers. 

• Follow all established policies and procedures for various QI workflows to ensure overall success. 

• Collaborate w/ customers, payers, co-workers to accomplish daily work. 

• Participate in all departmental and payer sponsored webinars/trainings/support calls throughout the year. 

• Communicate professionally and develop positive relationships with co-workers, customers, providers and providers’ support staff. 

Qualifications

WHAT YOU'LL NEED TO HAVE 

• Reliable transportation 

• LA state valid driver’s license and vehicle are required; periodic travel (up to 75%) is expected and reimbursed. 

• Required to pass drug screen

• Associate degree or greater in related field or certified/licensed professional-CMA, RMA, or  LPN required 

• Minimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction via EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding. 

• Minimum 2 years’ experience in Medicare Advantage Quality data abstraction and patient outreach 

• Tech savvy in managing the technical side of this position-working with health data, working in excel and PowerPoint, navigating multiple systems and applications. 

• Highly skilled in verbal and written communications. 

• Strong attention to detail, organized and ability to meet hard deadlines. 

• Ability to collaborate w/ others and work effectively with management, co-workers, and customers. 

WOULD LOVE FOR YOU TO HAVE