Quality Reporting Specialist

Summary

Join Aledade's growing Performance team as a Quality Reporting Specialist, playing a critical role in ensuring practice and ACO success in Medicare Advantage and commercial contracts. Focus will be on HEDIS quality measures, requiring expertise in reviewing charts (electronic and paper) to identify and submit documentation for quality measure gap closure. Strong attention to detail, communication skills, and a passion for quality measure performance are essential. This remote position involves minimal travel and requires a belief in Aledade's model of physician-led ACOs. The role includes working with HEDIS quality measures, submitting documentation to payers, retrieving documentation to address quality gaps, assisting with performance improvement plans, tracking progress, generating patient lists, attending meetings, and communicating with various stakeholders.

Requirements

• Experience working with the Medicare Advantage STARS program and HEDIS measures
• Bachelor’s degree is preferred or equivalent work experience
• 1+ years experience in primary care setting
• Comfortable working remotely from home/telecommuting
• Travel up to 25% (post pandemic restrictions)
• Computer skills and experience working with Google platform and Excel formulas/pivot tables
• Comfortable with exporting data, formatting, and reporting out results
• Track and communicate progress; escalate barriers to performance
• Able to work independently and prioritize deadlines
• Strong communication skills

Responsibilities

• Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient
• Receive training on payer-specific methods to submit documentation and employ optimal method in each practice (i.e., upload to payor portal, fax, secure email, etc)
• Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with practice staff to guide them through gap closures
• Assist in response to performance improvement plans
• Track quality gap closures per practice and document progress (i.e., X number of gaps addressed through submission during X hour practice visit or remote session)
• Have the capability to generate patient lists and from payer portals and explain to appropriate practice audience (i.e, office manager, care manager, nurse, physician)
• Virtually attend meetings with the Aledade internal team, practice staff and with payers as needed

Preferred Qualifications

Experience with Electronic Health Record system is preferred

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles
• Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
• Robust time-off plan (21 days of PTO in your first year)
• Two paid volunteer days and 11 paid holidays
• 12 weeks paid parental leave for all new parents
• Six weeks paid sabbatical after six years of service
• Educational Assistant Program and Clinical Employee Reimbursement Program
• 401(k) with up to 4% match
• Stock options