- Maintain responsibility for monitoring monthly and annual performance on quality targets across all health plans and health center partners.
- Update and maintain payer and FQHC crosswalk for performance detail tracking.
- Update, organize, and maintain month over month data folders and documents for performance actions (ie patient lists),
- Generate reports and presentations for health center meetings.
- Support the quality team in the development and implementation of a quality plan.
- Use clinical, member, financial and administrative data to identify and monitor actionable opportunities for improving performance based on Clinical Quality Program Manager direction.
- Organize and monitor the data for various quality strategies and programs including supplemental files, attribution management, outreach, and patient record reconciliation.
- Perform chart reviews and audits to validate information and support supplemental files.
- Incorporate continuous process improvement into daily work using critical thinking and problem-solving skills to address opportunities for improvement while promoting engagement of internal stakeholders in solution development.
- Conduct literature review for evidence based practices to support quality improvement initiatives.
- Support the quality team in development of partner tools and deliverables such as tip sheets, playbooks, and campaigns.
- Monitors year over year NCQA updates and/or changes.
- Perform any other duties as reasonably required by the Company.
- Bachelor degree in a health related field (preferred)
- 3 - 5 years of relevant experience
- Experience with primary care operations
- Experience working with various types of health organizations
- Highly organized with ability to document progress in an absorbable way
- Familiarity with Value Based Care model
- Experience with chart review and audits
- Experience with data processing, such as data hygiene, formatting and visualizations
- Familiarity with EMR and claims data
- Ability to communicate clearly and effectively
- Ability to take initiative in working independently as well as collaborate in a team environment
- Experience working in an early-stage startup
- Experience using Google Suite for data organization and use of other data platforms
- In-depth knowledge of technology and healthcare terminology
- Project management experience
- Familiarity with NCQA quality metric guidelines
- Quality Improvement and project management training/experience
- LPN/ RN Preferred
- Desire to learn and grow
- Bias towards action
- Team-oriented attitude, you derive joy from seeing others succeed
- Enthusiasm for and interest in health equity and innovation
- Unlimited vacation leave
- Paid parental leave
- Competitive medical, dental, and vision insurance
- $500 reimbursement for reasonable work equipment in the first year of employment
- Stock options
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Clinical Quality Specialist - New York, United States - Yuvo Health
Description
Job Description
Job DescriptionAbout YuvoYuvo works to increase access to primary care by supporting federally qualified health centers (FQHCs), the institutions that have dedicated the most to care for underserved communities. We work with FQHCs to help scale the quality of care they provide by providing access to new payment systems, developing and optimizing operational infrastructure, and convening partnerships in the broader care ecosystem so that they can increase their capacity and deliver the highest quality of care to their communities.
About The RoleYuvo Health is seeking a Clinical Quality Specialist with experience working with quality health metrics especially HEDIS to support driving health outcome performance. Reporting directly to the Clinical Quality Program Manager, this position will be responsible for understanding all assigned market measures and will support the population health team in preparing necessary deliverables to promote quality performance. The Clinical Quality Specialist will utilize clinical operation experience to support the cleaning and collating of various performance data sources, as well as analytics experience to support the monitoring of progress made toward metric goals. The (CQS) will be responsible for identifying important data findings and communicating to the Clinical Quality Program Manager. Additionally, the CQS will be responsible for organizing and maintaining intersectional information between payers and FQHCs.
At this time, Yuvo Health is not able to provide visa sponsorship or work authorization support.
What You'll DoBase Salary Range: $75,000 - $85,000/year
Our Benefits & Perks:
Our commitment to ensuring quality health care to underserved communities is the foundation of our commitment to diversity, equity, and inclusion in how we operate as a company and approach our work. Yuvo is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, age, gender identity and expression, sexual orientation, religion, national origin, socioeconomic status, disability, veteran status, or any other characteristic protected by law. With diversity, inclusion, equity, and belonging at the core of what we do, it is important to us to provide applicants with an inclusive, transparent, and fair candidate experience. We are happy to provide reasonable accommodations to those with a disability for assistance throughout the hiring process.
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