Quality Specialist at Crouse Hospital – Syracuse , New York

Why Crouse Medical Practice?

At Crouse Medical Practice, our focus is on improving the lives of our patients. This focus is what drives us to recruit the best employees to support our patients. Our practice fosters an inclusive environment that prioritizes work-life balance, welcoming individuals from all backgrounds to join our close-knit work family.

Here’s what we offer:

• Monday-Friday work week with no mandatory overtime
• Supportive team environment
• Competitive starting rates based on experience
• Annual salary increases
• Opportunities for professional growth & stability within a fast growing Medical Practice
• Longevity and consistency of management
• Perfect attendance award
• Tuition reimbursement program
• Employee referral program
• Affiliation with Crouse Hospital

Other benefits include: Generous Health/Dental/Vision & Life insurance, Flexible spending account or Health savings account – available first of the month following your date of hire, Employee assistance program,15 days of paid time-off within first year of employment, 7 paid holidays annually, and a 401k with 4% employer match

Position Description:

The Quality Specialist will support performance quality measures governed by NCQA and STAR measures. The purpose of this role is to help facilitate and maintain healthcare outcomes for our patients by providing closure of care gaps and preventative screenings through the use of disease

management and health maintenance tools and resources. This role will support efforts to maximize financial opportunities available through payer programs by also monitoring gap closure activities as it relates to data capture and roster management initiatives.

Position Specific Performance Standards


• Retrieves clinical documentation to identify and/or complete care gap closure utilizing every resource available including patient and external facility outreach.
• Assists with workflow analysis and identifies opportunities for improvement in the education and learning process and implement strategies to improve clinical excellence and operational efficiencies.
• Participate in schedule audit reviews and collaborate with clerical teams to ensure appropriate scheduling for rostered patients, including annual visit and visits or activities related to transitions of care gap closure
• Collaborate closely with Population Health for leveraging chronic care management and transitions of care workflows in support of gap closure for rostered patients
• Assist in projects related to medical records and ensuring the proper indexing of records related to health maintenance activities (i.e. proper coding of past and future medical records to accurately display “due rules” in health maintenance)
• Seeks medical records needed for gap closure from external providers (including eye care centers) and accurately indexes each document to the correct patient’s medical record, utilizing the correct document naming convention per best practice protocol.
• Demonstrates proficiency in retrieving and entering data into clinical systems including EHR and various payer platforms.
• Analyzes, verifies, tracks and reports on trends data. Extracts patient clinical data from medical records or other sources containing patient clinical data.
• Demonstrates proficiency in maintaining regulatory requirements for HEDIS, NCQA and CMS quality metrics/programs.
• Supports prospective review of gaps in care and opportunities to address through upcoming visit or patient outreach (directly or in collaboration with Care Management)
• Aids in insurance patient attribution utilizing payer patient lists and/or practice requests, including outreach to patients and payers to ensure appropriate assignment.
• Develops a relationship with the Ambulatory practices as an extended member of the care team to work towards network goals.
• Exhibits understanding of practice workflows to optimally identify opportunities and assists with quality improvement recommendations.
• Maintains productivity and accuracy standards, accordingly.
• Maintains confidentiality of all materials handled within the Network as well as the proper release of information.
• Perform patient outreach related to quality program measures
• Other duties as needed.


Qualifications



Experience: Minimum 5 years’ experience within a healthcare setting



• Excellent written, oral, and interpersonal skills with a strong customer service orientation.
• Ability to work independently and as part of a team.
• Ability to multi-task and manage workload that has competing priorities.
• Ability to see big picture and broader context and where quality priorities fit within this picture.
• Ability to understand and adhere to operational standards, policies, and procedures.
• Ability to use effective problem-solving skills and develop solutions for new challenges.
• Meets service standards by responding timely with patience, empathy and courtesy and high attention to details.

Pay Range: $18.50-$23.00 DOE