Quality Programs Partner presso MDX Hawaii

Company:

MDX Hawaii

Job Location:

Hawaii (Hybrid - Remote & In-Office)

Pay Range:

$55,000 - $80,000 per year

This salary range is a guideline. Individual compensation can vary based on factors unique to each candidate, such as skill set, experience and qualifications.

Position Summary:

This provider facing role collaborates with the Quality Programs Supervisor and team in the operations of provider programs. Communicates new provider programs, fields and responds to questions from providers and their staff. Engages with providers to drive performance through open communication and sharing actionable data for all quality programs.   Collaborates with internal and/or external teams to obtain necessary data and other resources to support/educate assigned providers. 

Essential Job Functions:

• With the guidance of the Quality Programs Supervisor, engages Providers and their office staff. This includes sharing actionable data with them and driving performance, consulting with department leadership to develop improvement where needed. 
• Engagement can be a combination of remote support (email, telephonic, virtual) and traveling to the practices to engage in person. With some practices there may be the need to embed the Quality Program Partner to best support the practice. Such assignment will be at Management’s discretion.
• Communicates new provider programs and fields questions from the providers and their office staff related to said programs. 
• Participates in the onboarding of any new providers or practices that join the network.
• Manages data needs and workflows, working with enterprise and local data teams as needed.
• Partners with practices regarding any identified tasks related to practice performance i.e., scheduling, chart retrieval, STARs abstraction, researching, auditing and visit preparation.
• Assists and possibly leads obtaining access for the providers, data needs, researching data issues, working with internal and external data teams.
• Works with practices to track all physicians joining and leaving their primary care teams.
• Assists with practice onboarding and tracking of deliverables, escalating barriers as needed.
• Assists with vendor operations, tracking performance and providing coordination between the vendor and provider offices.
• Performs data entry, report generation and tracking of metrics as requested.
• Assists and supports Management on projects as needed.
• Performs other duties as assigned.

Travel

Position is Hybrid with Remote and In-Office requirements. May require travel via own vehicle to provider offices. Ability to drive, valid Hawaii Driver's License and access to insured vehicle required. May require travel to Neighbor Islands.

Required Qualifications: 

1. Minimum Experience
   1. 2+ years of experience within healthcare, managed care operations, health plan, hospital, or provider practice operations. 
   2. Experience and knowledge in at least one of the following: Risk Adjustment, Quality/STARs, Medical Loss Ratio (MLR), Population Health Management, Contracting, Provider Network Operations, Provider Services, or Claims. 
   3. Preferred experience with managed care products, healthcare operations, delivery systems, process improvement or organizational effectiveness
2. Education/Licensure:
   1. Associate’s degree, Bachelor’s degree; or equivalent work experience required.
   2. Current valid Hawaii State Driver's license and Proof of Hawaii No-Fault Auto Insurance. Clean driving record as evidenced by a recent driver's abstract.

Skills and Abilities:

1. Ability to be a team player and exercise initiative in responding to provider requests and concerns in a helpful and courteous manner.
2. General understanding of the health care industry, ideally the provider relations field-desired.
3. Excellent interpersonal and telephone communication skills are required.
4. Exercise attention to detail.
5. Ability to work under pressure with minimal supervision, multi-task, complete projects in a timely fashion and meet deadlines a must.
6. Autonomous, Driven, Self-starter, analytic/critical thinker
7. Excellent analytical, problem solving and organizational skills a must.
8. Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment.