The Quality Reporting Specialist plays a critical role ensuring practice and ACO success in Medicare Advantage and commercial contracts, with a focus on HEDIS quality measures. Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans. Submit documentation to health plans and employ the optimal methods in each practice.
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- Manage a team of Clinical Specialists and independent contractors.
- Develop and deliver clinical education to sales, clinical specialists, marketing, surgeons, and OR staff.
- Collaborate with Quality, Regulatory, Marketing, and R&D to develop clinical education around new product development.
- Design and deliver structured onboarding for physicians, NPs/PAs, and dietitians.
- Train clinicians on Form Health’s proprietary technical platforms.
- Create and provide training on medical workflows, EMR documentation standards, and patient engagement best practices.
As Clinical Trial Manager, you will lead CRAs and oversee clinical aspects of studies across multiple countries. You will ensure timeline adherence and scope, whilst ensuring quality delivery. Management and operational delivery of the clinical elements within a trial including site selection, start-up, and data cleaning activities. Identify challenges to study timelines/deliverables and offer creative action plans to the team/sponsor.
- Provide ongoing support to providers to help them maintain high-quality care delivery and professional growth.
- Monitor, track, and respond to clinical adverse events.
- Work with Customer Support, Product, Provider Success, Clinical Quality, and Care Coordination teams to execute end-to-end clinical roadmaps and SOPs.
As a Coder II, you will review and process complex specialty clinic professional charges for Dignity Health Medical Foundation. Codes complex office, surgical and hospital professional charges for assigned providers Provide education to physicians and providers on coding and documentation, as needed.
Healthcare operations leader with deep expertise in quality improvement across diverse provider networks. Responsible for overseeing the performance and reliability of the organization's network infrastructure. Leads cross-functional efforts that improve provider engagement, optimize workflows, and elevate overall network performance.
- Lead the development and management of virtual care programs.
- Manage and support a remote team of Nurse Practitioners.
- Collaborate with cross-functional teams to optimize virtual care workflows.
- Proactively provides education on access and reimbursement topics.
- Manages the pull-through of access and reimbursement strategy within aligned accounts.
- Communicates requirements and addresses barriers associated with payer policy coverage.
- Develop and execute educational programs for physicians and healthcare professionals.
- Collaborate with sales leadership and the marketing team to develop learning content.
- Support program metrics and reporting.