Hcc Project Specialist

Job Description
Position Summary:
The STAR/P4P/ACO Project Specialist performs the functions related to the patient and provider outreach for quality measures. In addition, this position will assist in creating programs for chronic illnesses to improve the care of patients. For example, the Project Specialist will assist in coordinating the diabetic patient and provider outreaches. He/She will also assist in creating and coordinating a similar program for the ACO population. The Project Specialist may also work with pharmacists throughout the organization to achieve the goal of high quality scores. This position requires excellent reading comprehension skills in order to analyze and process the information collected and distributed. The Project Specialist must be detailed in obtaining and reviewing the applicable medical records and clinical criteria and must behave in a professional manner when interfacing with Medical Directors, physicians, office staff and other internal and external customers. The Project Specialist will also audit HEDIS Coordinator work for quality assurance.
Essential Duties and Responsibilities include the following:

• Assist in developing programs, mailers, campaigns for promoting the necessary services and required screenings.
• Create and run programs and outreaches to achieve improved outcomes on quality measures especially those related to medications and chronic diseases.
• Interface with physicians, vendors, members, and internal staff telephonically or in person to obtain data and to obtain information.
• Provide education in regards to STAR/P4P/ACO quality measures especially those related to medications and chronic diseases to internal and external staff, as needed.
• Work with other departments and employees to create a workflow that achieves company goals related to specified quality measures and improved patient care.
• Communicate professionally with providers and patients as part of the department's outreaches.
• Remain updated on NCQA HEDIS Technical Specifications and ACO specification as it applies to STAR/P4P/ACO quality programs.
• Interface with data support and IT to collect and track data.
• Filing, faxing, copying and scanning of files.
• Strive to meet personal, departmental and organizational goals and targets.
• Ability to manage a heavy workload with frequent interruptions and changing priorities in a fast paced environment.
• Completes assignments within specified time lines.
• Able to work well in a team environment on special projects.
• Skill in working independently, but with supervision.
• Prepares and maintains records and files that are organized, thorough and readily accessible.
• Assist in updating policies and procedures.
• Attend regular team meetings and report findings of data collection and projects.
• When identifies a problem, informs supervisor in a timely manner so the problem can be corrected.
• Transmits ideas and information in a clear and concise manner.
• Assist supervisor with special duties/projects including coordinator audits.
• Other duties as assigned.

The pay range for this position at commencement of employment is expected to be between $22.50 - $24.50 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:

• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Vision insurance
• Zero co-payments for employed physician office visits
• Flexible Spending Account (FSA)
• Employer-Paid Life Insurance
• Employee Assistance Program (EAP)
• Behavioral Health Services

Savings and Retirement:

• 401k Retirement Savings Plan
• Income Protection Insurance

Other Benefits:

• Vacation Time
• Company celebrations
• Employee Assistance Program
• Employee Referral Bonus
• Tuition Reimbursement
• License Renewal CEU Cost Reimbursement Program
• Business-casual working environment
• Sick days
• Paid holidays
• Mileage

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.
Requirements
Education and/or Experience:

• High School diploma.
• One year experience in clinical setting preferred.
• 2+ years of HEDIS experience required.
• Familiarity with managed care, commercial and point of service medical care preferred.
• Computer literate with knowledge and experience with specific software such as Word, Excel, Access.