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Aledade is the largest network of independent primary care.
The Role
The Quality Reporting Specialist ensures success in Medicare Advantage and commercial contracts through knowledge of HEDIS measures and quality gap closures. They coordinate with field teams and manage health records, documenting and reporting results while working independently and providing feedback.
Summary Generated by Built In
The Quality Reporting Specialist plays 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. This role requires strong attention to detail, great communication skills (both oral and written), and a passion for quality measure performance.
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the U.S.
Primary Duties:
- Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient
- Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with field team to assist guiding practices through gap closures
- Submit documentation to health plans and employ optimal method in each practice (i.e., upload to payor portal, secure email, etc)
- Coordinates Electronic Health Record (EHR) system access set-up & login management
- Consult with market field team members on quality reporting strategy - providing relevant market updates and chart review feedback for assigned practices
Minimum Qualifications:
- 1+ years experience in quality reporting in healthcare or health plan setting
- Experience working within at least one (1) major Electronic Health Record system (athenaHealth, eCW, etc)
- Comfortable exporting data, formatting and reporting out results (Excel or Google Sheets experience)
- Able to work independently and prioritize deadlines
- Track and communicate progress; escalate barriers to performance
- Strong written and verbal communication skills
- Strong attention to detail
Preferred KSAs:
- Bachelor’s degree is preferred or equivalent work experience
- G-Suite Proficiency
- Experience working with the Medicare Advantage STARS program and HEDIS measures
Physical Requirements:
- Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
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 collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much 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.
Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants
Top Skills
Electronic Health Record
Excel
Google Suite
Google Sheets
Hedis Quality Measures
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The Company
What We Do
Aledade is the largest network of independent primary care, enabling clinicians to deliver better patient outcomes and generate more savings revenue through value-based care. Aledade’s data, personal coaching, user-friendly workflows, health care policy expertise, strong payer relationships and integrated care solutions enable primary care organizations to succeed financially by keeping people healthy. Together with more than 1,900 practices and community health centers in 45 states and the District of Columbia, Aledade manages accountable care organizations that share in the risk and reward across more than 200 value-based contracts representing more than 2.5 million patient lives. To learn more, visit www.aledade.com or follow on X (Twitter), Facebook or LinkedIn.
Why Work With Us
At Aledade, we’re all about doing good for patients, practices and society - which is why we’re so passionate about value-based care and the work we do every day. Because we’re working to benefit all of society, we believe the best way to do so is to utilize all of our team members and their unique experiences, interests, backgrounds and beliefs.
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