Provider Quality Consultant – Hybrid to Indianapolis

Description

Provider Quality Consultants will assist with all levels of provider engagement in quality performance programs. This position will provide both in person and virtual support to identified and assigned provider offices.

• Recommend workflow efficiencies to providers and their staff to improve HEDIS scores and desired patient outcomes.
• Train provider offices on specific provider incentive programs, secures participation, tracks progress, and makes recommendations for success.
• Identify member service gaps and review reports with providers and their staff.
• Works with providers to actively close identified service and care gaps
• Actively partner with corporate CDT and Health Care Network teams.
• Monitors and validates member attribution lists and provider directory information in alignment with contract requirements.
• Assists with medical record review, supplemental data submission, abstraction, overreading as necessary to meet Health Plan goals.
• Additional quality management and improvement tasks as identified.

Salary: $ 36.05-43.27

Requirements

Qualifications:

• Experience working with providers and provider office staff.
• Clinical background as LPN, RN or LCSW or other applicable license or certification      as determined by the Company is preferred.
• Effective verbal and written communication skills
• Excellent interpersonal skills
• Ability to juggle multiple priorities simultaneously.
• Innovative critical thinker
• Ability to work independently and productively in a remote environment.
• Excellent project management and organizational skills
• Knowledge of and experience working in EMR systems