Job Information
Renown Regional Medical Center Quality Performance Specialist in Reno, Nevada
POSITION:
Quality Performance Specialist
REQ #: 182057
SCHEDULE: Full time; Day Shift;8:30 - 5:30; 40 hours/week
LOCATION: Reno, NV
SALARY: Will discuss with applicant. Actual salary offered may vary based on multiple factors, including but not limited to, an individual's location and their knowledge, skills, and experience as well as internal equity.
TO APPLY:
Direct Link - https://pm.healthcaresource.com/cs/renownhealth/#/job/53915
Careers Page - https://www.renown.org/Careers/
*Please note, employers may close jobs on the website at any time. *
SUMMARY:
Under the direction of leadership, assists the Quality department in coordination, development, and implementation of regulatory and accreditation programs such as HEDIS, NCQA, CMS and State of Nevada quality improvement programs (QIP). This position participates in the development of policies and procedures, standard work and educational materials for staff, members, and network providers to support increased performance based on data surrounding the QIPs as well as ensuring and enforcing proper medical record documentation. Additionally, this person will be both member and provider facing coordinating and educating on regulatory quality programs and assisting in the closure of required gaps in care. The Quality Performance Specialist coordinates with both the Quality Improvement team, Risk Adjustment team, and outreach coordinators in care gap initiatives
MINIMUM/PREFERRED REQUIREMENTS:
Education: Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelors degree in public health or other healthcare related degree, or equivalent work experience preferred Bilingual preferred, but not required.
Experience: Requires two years of experience in a position involving public health or patient care. Experience with regulatory programs or accreditation, such as HEDIS, NCQA or CMS is preferred. Knowledge of medical terminology required.
License(s): None
Certification(s): Current AHA BLS/CPR or ability to obtain within 90 days of employment required. Current Certified Medical Assistant (CMA) certification, Registered Medical Assistant (RMA), Certified Clinical Medical Assistant (CCMA), National Certified Medical Assistant (NCMA) required upon hire.
Computer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
JOB RESPONSIBILITIES/DUTIES:
This position facilitates the key quality functions such as member rewards programs, provider pay for performance programs, documentation of quality outcomes, and facilitation of provider group Joint Operating Committees (JOC). This position also develops provider and member communications and education from the QI department. This role acts as a facilitator and coordinator for all formal QI committees that role up to the board of directors, while ensuring that we have met all required regulatory and accreditation requirements.
This position is responsible for the collection and confirmation of accuracy of documentation to support HEDIS and NCQA requirements. This position works with healthcare providers to retrieve supporting medical record documentation to be submitted to the certified HEDIS vendor throughout the year. This position also acts as a resource to supporting contract staff during annual HEDIS and other regulatory audits.
The essential responsibilities of the position are:
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