Director, HEDIS, Stars, and Quality - InHealth MD Alliance LLC

IMA Medical Group is seeking to hire a full-time Director, HEDIS, Stars, and Quality.

The Director, HEDIS, Stars, and Quality in collaboration with the Chief Nursing Officer and Chief Medical Officer is responsible for the overall strategy for improving the company’s HEDIS and Stars results and ensuring high quality of care for the patients we serve.

As a Full-Time IMA employee, you will be eligible to participate in our amazing benefits such as:

• Low-Cost Medical, Dental and Vision Insurance
• Employer Paid Life Insurance
• Voluntary Short-Term Disability and Life Insurance
• Voluntary Illness and Accidental Insurance
• 401K
• PTO
• Paid Holidays

Responsibilities

• Develops strategic performance improvement plans to improve Stars ratings across all payors, including identifying critical areas to improve to ensure patients are receiving the highest quality care while also increasing and maximizing the revenue for the company.
• Maintains up-to-date advanced knowledge of HEDIS, Stars, Medication Adherence, and Patient experience (CAHPS / HOS) measures.
• Leads monthly quality meetings with organizational leadership to evaluate metrics and identify and remove barriers to improving metrics across the organization.
• Responsible for performance monitoring and operational reporting with monthly executive summary to leadership which includes Star scores along with projected revenue impacts.
• Responsible for meeting with each payor monthly to monitor performance and develop specific action plans to maximize quality for each payor.
• Attend health plan Joint Operating Committees to represent and communicate the organization’s Stars and Patient Experience initiatives and performance.
• Required to improve CAHPS and HOS measures working with payor partners and our internal teams to identify areas of opportunity for improvement and create action plans to address.
• Create collaborative working relationships across the organization to advance the quality of care for our patients.
• Reviews and collaborates with leadership to identify workflow improvements to improve HEDIS, Medication Adherence, Patient Experience, and Stars metrics.
• Responsible for MIPS reporting as needed for the Medicare FFS population.
• Ability to work independently with limited supervision and as part of a team.
• Capacity to work in a fast-paced environment and complete multiple tasks at the same time.

Requirements

• Bachelor’s degree in nursing or other clinical specialty
• 7 + years of experience working with HEDIS and Stars
• 5-7 years of leadership experience
• Advanced knowledge of HEDIS / Stars and CAHPS / HOS measures and methodologies
• Managed Care experience
• Strong analytical, problem-solving, and critical thinking skills.
• Excellent written and verbal communication skills.
• Ability to work independently and in a team environment.
• Demonstrated ability to manage multiple projects simultaneously.
• Expert proficiency in Microsoft Office product suite including PowerPoint and Visio.

Preferred

• Master’s degree in business, health management or other related field.
• Fully bilingual (English/Spanish)

ARE YOU READY TO JOIN OUR TEAM?

We understand your time is valuable and that is why we have a very quick and easy application process. If you feel that you would be right for this position. please fill out our initial 3-minute, mobile friendly application so that we can review your information. We look forward to meeting you!

IMA Medical Group is an Equal Opportunity Employer (EOE) and we comply with all federal, state and local anti-discrimination laws, regulations and ordinances.

IMA Medical Group participates in E-Verify, as required by the Florida Medicaid program.

IMA maintains a drug-free workplace in accordance with applicable Federal and State laws.