Director Of Quality And Risk Adjustment Job Physicians Medical Group /Excel MSO Joseby admin on July 1, 2020
Physicians Medical Group /Excel MSO Job Vacancies 2020Description :
Director of Quality and Risk Adjustment
We are looking for a Manager of Quality who wants a rewarding career working to improve the quality of care our members receive! If you have Medi-Cal or Commercial HEDIS quality program experience as well as experience in managed care quality (health plan or medical group), we want to talk with you. For 40 years, Physicians Medical Group of San Jose has cared for Santa Clara County patients. Our teams work with our providers to identify and close preventive care, chronic condition and other HEDIS, STAR and IHA-AMP care gaps. All of our team members get extensive training and support! All of our team members are bonus eligible! This position works out of our North San Jose office. Some work from home is possible. If you want to be part of a dynamic, collaborative group, apply now!
- Lead Quality team to meet HEDIS quality and other quality SMART goals
- Develop, implement and monitor strategic and tactical quality programs to meet goals by Line of Business and individual health plans.
- With Chief Medical Officer, work with Provider office staffs, Providers and Provider Relations to implement programs designed to achieve accurate, timely and comprehensive documentation of care
- Work with Health Plan Quality groups to collaborate on care opportunities. Lead annual IHA-AMP audit.
- Responsible for all quality operations including administratively managing Committees
- Work with Steering Committee to roll-out our internet based, easy-to-use PCP dashboard for Quality measurement and HCC reporting (COZEVA)
- With Compliance, assist with delegation oversight audits, quality investigations, appeals and grievance resolution. Responsible for CAP responses for quality issues.
- Work with Provider Relations to investigate and resolve provider and other quality issues as arise; trend, track and reporting information.
- Bachelor’s degree required. In addition, background in business analytics and statistics strongly preferred.
- 3-5 years’ experience in managed care quality. 3 or more years’ experience with HEDIS programs, either Medi-Cal (Medicaid) or Commercial (IHA)
- 3-5 years direct management experience. (health plan, medical group or primary care clinic setting)
- Project management experience. Experience working with Providers and Provider Relations
- Strong written and oral communication skills
- Proficient with Microsoft Office (Word, Excel, Outlook) is required.
- Organizational skills sufficient to work on multiple projects simultaneously within established timeframes
Job Type: Full-time
- 401(k) Matching
- Dental Insurance
- Disability Insurance
- Employee Assistance Program
- Flexible Spending Account
- Health Insurance
- Life Insurance
- Paid Time Off
- Vision Insurance
Excel MSO is currently following CDC/OSHA and SCCHHS guideline with regards to Covid-19. we are currently accepting resumes via Indeed and doing phone screening/interviews.
- Monday to Friday
- Temporarily due to COVID-19
For further information, please refer official source from Physicians Medical Group /Excel MSO on following link below. To find out where you fit in, please visit :
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