Value Base Care Initiatives Analyst
The Value Based Care Initiatives Department is critical to the overall success of the company. New and established Health care providers value great service and maintenance throughout the term of the agreement. Service includes management of HCC and STARS, contracting with providers, providing excellent customer service to the network, and consistent telephonic, face-to-face and written communication and interaction in order to establish and retain positive and successful relationships with the provider network.
Design, create, implement, manage, and modify detailed analysis tools for STARS/HCC Departments.
Run updated individual physician lists of eligible members for STAR measures and HCC diagnosis.
Reconcile STARS/HCC reporting data from multiple sources and routinely generate reports.
Enter clinical data that substantiates compliance and validation into qHealth/qMetrics.
Research and coordinate processes to obtain data from Health Net for STARS/HCC reporting and planning purposes.
Use technology software (GeoMap, SQL, Microsoft Programs, and other) to assist in VBCI initiatives for network and member outreaches.
Maintains up-to-date physician P4P profiles and assists with reports/paperwork for P4P payout.
Implement interdepartmental analytical solutions for STARS/HCC productivity efficiency and effectiveness.
Valid AZ Driver's License
Prior experience with HCC and STARS Knowledge of qMetrics, EZCap & NextGen preferred. Knowledge of SSRI and SSRS preferred Excellent level proficiency with Microsoft Office applications including Word, Excel, Power Point, Access, SQL.
Bachelor's Degree in Computer Science requred