[Hiring] Quality Practice Liaison @CVS Health

Role Description

This is a full-time Quality Practice Liaison opportunity with the Arizona Mercy Care Plan. The working schedule is Monday- Friday during normal business hours. This is a typical office working environment with productivity and quality expectations.

The Quality Practice Liaison position is a work at home role. This person must be comfortable presenting HEDIS® gaps in care data to provider groups, including HEDIS® (Healthcare Effectiveness Data and Information Set) measure education and best practice information. Responsibilities include:

• Obtaining, reviewing, abstracting, and data entering medical records utilized for HEDIS® supplemental data processes.
• Understanding the NCQA (National Committee for Quality Assurance) HEDIS® technical specifications for designated HEDIS® supplemental data measures.
• Collaborating with health plan HEDIS® project managers and other health plan departments to improve member outcomes, as measured by the HEDIS®/STAR measures.
• Accessing a variety of EMR systems remotely to obtain and abstract medical record data per specifications.
• Meeting volume and accuracy expectations communicated by management.
• Reading and interpreting medical record documentation, both computer-generated and handwritten.
• Sitting at a workstation for extended periods of time typing on the computer.

Primary Responsibilities include:

• Generating and distributing gap in care reporting from Tableau Dashboard.
• Actions outreach, scheduling meetings, developing presentations, and conducting meetings with provider groups to share HEDIS information.
• Reviewing documentation and abstracting compliant medical record data for entry into supplemental data tool.
• Contacting the providers of record, vendors, or internal Aetna departments to obtain additional information as needed.
• Commanding a comprehensive knowledge of NCQA HEDIS and STARS Measures for both Medicare and Medicaid.
• Working with a variety of electronic tools to accomplish team goals.
• Performing other duties as needed.

Qualifications

• 2+ years of experience with HEDIS quality measures.
• 1+ years of experience with delivering presentations.
• Demonstrated proficiency in technology, keyboarding, and various systems, including Microsoft Outlook, Teams, Word, Excel, PowerPoint, Adobe Acrobat, Windows 10, and QuickBase.
• Must reside in Arizona.
• Willingness to travel in the state of Arizona up to 10% of time.

Requirements

• High level of accuracy and attention to detail.
• Self-motivated and comfortable working under tight deadlines.
• Professional customer service demeanor, good work ethic, and ability to self-motivate.
• Conscientious problem solver, with a demonstrated willingness to learn.
• Proven organizational and time management skills.
• Excellent verbal & written communication skills, with a focus on clear, concise, and appropriate language.
• Experience with a variety of EMR (Electronic Medical Records) systems.
• Ability to multi-task, prioritize, and effectively adapt to a fast-paced, changing environment.
• Experience reading and interpreting medical records, including handwritten records.
• Active and unrestricted Arizona or compact state RN (Registered Nurse) license.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.