Qi Data Coordinator

WHO IS GUIDEHEALTH?

At Guidehealth, our mission is to enhance healthcare affordability for patients and restore the fulfillment of practicing medicine for providers. As a physician-led company, we recognize that streamlining administrative tasks and harnessing the power of predictive analytics and AI enable our partner physician practices to prioritize delivering high-quality healthcare focused on outcomes and value.

Driven by empathy, we empower physicians to anticipate the needs of patients requiring more attention, strengthen connections between patients and physicians with virtually-embedded Healthguides, and leverage AI and analytics to proactively avoid preventable events. This approach results in increased levels of patient and practice engagement, ultimately leading to more significant positive impacts on patients.

Join us as we put healthcare on a better path!!

This position is responsible for assisting the Population Health Case Management Team on reporting services, communications, and coordination for one or more of the day-to-day functions. (e.g., customer service, reporting, medical record lookup, email, report reviews and distribution, and data entry.)

WHAT YOU WILL BE DOING:

• Subject Matter Expert (SME) on entire scope of QI Fund, particular focus on QI Projects, for assigned IPA/s and demonstarted proficiency around the more seasonal ACO quality reporting work 
• Collect quality measure data using using various methods of collection  
• Meet all project deadlines and requirements by completing MXO Forms and uploading all supporting documentation per BCBSIL requirements 
• Prepare and deliver monthly QI updates to assigned IPA/s w/ focused approach on QI projects performance, earnings, barriers and improvement strategies 
• Proficiency w/ reporting out overall financial data to assigned IPA/s relative to the QI Projects and larger QI Fund  
• Respond to any IPA requests for additional insights, data or reports around particular quality metrics 
• Proficiency and confidence w/ navigating various computer applications and software.  For example, Excel for patient lists/gap lists/performance graphing, PowerPoint for meetings, EMR system/s for data collection, Access for claims searches, Availity/intranet for BCBSIL eligibility, MXOTech for BCBSIL project rosters/submissions/results, Guidehealth QI Application for BCBSIL project data entry and project management, ACO Health Solutions for ACO quality reporting, Oulook for email and Slack for IMs. 
• Proficient use of quality resources to ensure accuracy and completeness of work-measure/project instructions, NCQA/HEDIS specifications, coding documents, cheat sheets, quick reference guides. 
• Follow all established policies and procedures for various QI workflows to ensure overall success 
• Collaborative work w/ client IPAs, ACOs, BCBSIL and Guidehealth VBCMs, Population Health Nurses, UM Nurses 
• Complete required annual outreach per BCBSIL for assigned IPA/s.  Work collaboratively w/ QI team to accomplish, apply creative thinking around outreach approaches. 
• Participate in all departmental and payer sponsored webinars/trainings/support calls throughout the year 
• Communicate professionally and develop positive relationships with co-workers, IPA and ACO leadership, providers and providers’ support staff 
  

WHAT SUCCESS LOOKS LIKE IN 3 MONTHS

• Complete QI Departmental training, orientation and shadowing 
• Have a solid understanding of QI department scope of work and assigned IPA 
• Begin to take QI responsibility for assigned IPA while partnering w/ a seasoned QI co-worker 
• Begin managing, collecting and reporting quality data per established workflows 
  

IN 6 MONTHS

• Moving towards independence w/ QI ownership of assigned IPA w/ periodic support from QI team 
• Taking lead or co-lead on QI portion of client meetings and meeting preparations 
• Occassional support/direction needed 
  

IN 12 MONTHS

• Fully independent w/ complete QI ownership of assigned IPA  
• Display understanding and confidence for ACO quality reporting

WHAT YOU'LL NEED TO HAVE

• Associate degree or greater in related field or certified/licensed professional-CMA, LPN 
• Minimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction via EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding  
• Tech savvy in managing the technical side of this position-working with health data and formulations for earnings, working in excel and PowerPoint, navigating multiple systems-EMRs, payer portals, data bases  
• Highly skilled in verbal and written communications.  

WE WOULD LOVE FOR YOU TO HAVE:

• Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers. 

WHAT YOU GET

• Use your skills to make a meaningful impact in healthcare 
• Work with a great team in an awesome work environment  

COMPENSATION

Guidehealth’s compensation structure includes more than just base salary. We believe in providing world-class benefits including comprehensive medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. Our paid time off program includes paid holidays and flexible time that focuses on meeting the demands of the position and our clients, while providing the balance that our employees need.

The base pay range for this role is between $20 to $23 per hour paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging is at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. 

This position is responsible for following all Security policies and procedures in order to protect all PHI under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.  For any security-specific roles, the responsibilities would be further defined by the hiring manager.