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Commercial Quality Specialist, Remote

Company: Aledade
Location: Houston
Posted on: May 5, 2021

Job Description:

We are actively recruiting for Commercial Quality Specialists to join our growing Aledade Performance team. The Commercial Quality Specialist will play a critical role ensuring practice and ACO success in our Medicare Advantage and commercial contracts with a focus on HEDIS quality measures. The Specialist must be service-oriented, well-versed in HEDIS quality measures, and familiar with approaches for reviewing ambulatory care charts both electronic (EHRs) and paper to identify and submit documentation to address quality measure gap closure. Additional consideration for candidates familiar with addressing medication adherence measures. This role requires strong attention to detail, great communication skills (both oral and written), and a passion for quality measure performance. We are looking for individuals who genuinely believe that Aledade's model of physician-led ACOs can improve quality and lower cost. This role is a remote position within the US and candidates must be available to travel 25% when it's safe to do so again.Your footprint & specific duties within role:* Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage 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 (ie, 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 (ie, 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 (ie, office manager, care manager, nurse, physician)* Virtually attend meetings with Aledade internal team, practice staff and with payers as neededAdditional qualifications* 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* Experience with Electronic Health Record systems is preferred* 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* Desire to think beyond their immediate team and contribute to making Aledade holistically better (active engagement in D&I efforts, culture initiatives, facilitating training, leading roundtables, etc.)If you are passionate about transforming the healthcare system into one that best serves the needs of patients, doctors, and society, we'd love for you to join us!Who We Are:Aledade is a leader in population health that is using innovative, value based solutions to transform the way physicians interact with their patients. We are on a mission to change healthcare for the better and solve complex problems within the healthcare system.We follow the simple but radical idea that Aledade only succeeds when our partner practices succeed. From our cutting-edge technology platform to practice transformation services, we provide physicians with everything they need to create and run an accountable care organization (ACO), revamping the way they practice and getting them back to where they should be: quarterbacking their patients' health care!Our customized solutions help clinicians in communities across America preserve their autonomy, deliver better care to their patients, reduce overall costs, and keep independent physician practices flourishing.What Does This Mean for You?At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness, and a desire to learn. You will work with team members that bring a wide range of experiences, interests, backgrounds, beliefs, and achievements to their work, united by a shared passion for public health and a commitment to the Aledade mission.We've recently been recognized as a Top Workplace by The Washington Post, Best Workplace in HealthCare & Biopharma, Top 100 Best Small & Medium Workplaces, Glassdoor Best Places to Work, a Best and Brightest Companies to Work for in the Nation, a Tech Tribune 10 Best Tech Startups in Maryland and Bethesda, Best Tech for Good, Best Workplaces for Millennials, Best Workplaces for Women, Best Workplaces for Parents, and a 2020 Inno on Fire by DC Inno.That's because the things that matter to you also matter to us!In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the needs of our team-members:Flexible work schedules and ability to work remotely available for many rolesEducational Assistant ProgramRobust time off plan (21 days of PTO in your first year!)Paid Volunteer Days10 paid holidays12 weeks paid Parental Leave for all new parents6 weeks paid sabbaticalHealth, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners401(k) with up to 4% matchStock optionsMonthly cell phone stipendWeekly catered lunchesJeans everyday workplaceGender neutral bathroomsAnd more!At Aledade, we don't just accept differences, we celebrate them! We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

Keywords: Aledade, Houston , Commercial Quality Specialist, Remote, Other , Houston, Texas

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