Under the supervision of the Director of Operational Excellence the Quality Incentive Programs Coordinator will be accountable for the daily duties related to achieving deliverables for government and health plan Quality Incentive Programs. The Quality Incentive Programs Coordinator will have responsibility for ensuring all requirements are met by SJHH providers for attestation, serves as the point of contact for internal and external inquiries on payment or performance status. This position will partner with Decision Support teams to obtain data and perform high level analysis on SJHH's performance trends. In addition, this position will support Performance Improvement teams to communicate opportunities in performance.
- Serves as a subject matter expert on Meaningful Use (MU) Core and Clinical Quality Measures, including Physician Quality Performance System (PQRS).
- Review individual provider performance via Reports Manager and provide information on low performing providers to Performance Improvement teams.
- Conduct registration and manage proxy process for MU attestation for all providers.
- Responsible for serving as the point of contact for COREC and submitting required documentation.
- Supports Meaningful Use Project Manager in preparing for attestation including analysis and problem solving by looking at individual provider Meaningful Use performance, reviewing Medi-Cal thresholds, etc.
- Responsible for submitting Medicare and Medicaid attestation for each provider.
- Collates and submits MU audit documentation under the guidance of Meaningful Use Project Manager.
- Conduct research on prior MU participation by new St Joseph Heritage providers.
- Initiates and manages continued follow up with CMS on technical and other issues on provider MU accounts (e.g., registration issues, delayed payments).
- Collaborate with PQRS data submission vendors (DSV) to ready the EHR data for PQRS submission, which includes registration and the process of obtaining provider signatures for attestation.
- Assisting the Performance Improvement teams with analysis of each provider’s performance to identify the clinical quality measures that will be attested for with PQRS.
- Assist coworkers within our department and other departments with projects and tasks as needed.
- Follow up on actions required, respond in a timely manner, meet scheduled deadlines, devise and implement contingent plans as needed.
- Must be proficient with MS Word, Excel, PowerPoint, Outlook and internet navigation.
- Requires strong written and verbal communications skills to communicate effectively with individuals at all levels of the organization.
- Must be able to work under general supervision.
- Must have a professional and mature demeanor.
- Must be able to work in a fast-paced department and handle multiple tasks, work with interruptions, and deal effectively with confidential information.
- Knowledge of Six Sigma Quality Improvement and Lean Production/Manufacturing processes and tools, preferred.
Minimum Position Requirements:
Experience: 1 year experience in a health care setting or medical claims/insurance operations.
Preferred Position Qualifications:
- 5 years experience in a health care or managed care system.
- Project management experience in an ambulatory care environment.
- Experience with Six Sigma Quality Improvement and Lean Production/Manufacturing processes and tools.
Licenses/Certifications: PMI Project Management Professional certification