HEDIS-Stars Staff Assistant

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 3,500 providers including Primary Care, Specialty, Hospital System and ancillary provider partnerships. We have operated in the Arizona market for more than 11 years, and are based in Chandler, Arizona. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

To review, assist, and communicate with the STAR team, administration, providers, and members regarding HEDIS/Stars initiatives on behalf of Arizona Priority Care. The position is to assist coordinated efforts of closing Star measures, including reviewing medical records available for captured Star measure compliance and load data into internal systems. The position also provides assistance conducting member and provider outreach, obtaining status updates, and initiating reminder communications for measure compliance.

POSITION DUTIES & RESPONSIBILITIES

· Review medical records to identify, document, and upload Star measures that substantiate compliance into necessary database(s).

· Review physicians’ reports to analyze Star measures needed in order to assist in the individualize request for medical records.

· Enter documentation of captured Star measures into systems and tracking logs.

· Demonstrate superb customer service skills while communicating with internal and external individuals, providers and members.

· Assists in telephonic outreach to providers, pharmacies, and members for Star measure initiatives, including medication adherence.

· Access Health Plan and internal reports & systems to analyze status of Star measures, including medication adherence, in preparation of telephonic outreach.

· Demonstrate professionalism in documentation of outcomes and status update within Health Plan & internal systems and reports.

· Assist in the preparation of audits conducted by contracted Health Plan(s).

· Review and understand the technical specifications of HEDIS/Star measures.

· Support and maintain an environment which fosters high customer and employee satisfaction and quality service.

· Perform other duties as assigned.

EDUCATION, TRAINING AND EXPERIENCE

· High school diploma required. College degree preferred.

· Arizona Medical Assistant certification preferred.

· Minimum 1 year experience in healthcare or managed care setting with responsibility for systems and/or projects.

· Knowledge of q.hmo, EZCap & NextGen preferred.

· Ability to find, gather, and collect information or data.

· Excellent written and oral communication skills.

· Ability to work independently once oriented to routine and process.

· Intermediate level proficiency with Microsoft Office applications including Word, Excel, Power Point, and Access.

*This role requires FT in-office presence for the first 60 days of employment. Hybrid schedule available after initial training period.*