HEDIS-Stars Quality Care Coordinator - Medical 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 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 13 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. 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 assist, and communicate with the Star Team, administration, network providers and members regarding HEDIS/Stars needs within the IPA community.

POSITION DUTIES & RESPONSIBILITIES

• Complete Biometric tests and preventive health screenings, including eye retinal screenings, body mass index, blood pressure, bone density scans, HbA1c, etc.
• Travel independently and/or with AZPC's clinical team to members'/beneficiaries' home of clinical facilities.
• Conduct member outreach, providing education and reminders on preventive health status completions.
• Conduct outreach to schedule AZPC clinical appointments.
• Assist in member outreach for medication maintenance and adherence.
• Request medical records and assist in HEDIS/STARS record abstraction efforts.
• Communicate interdepartmentally to provide and obtain related STAR reports and status updates.
• Request medical records and assist in HEDIS/Star record abstraction efforts.
• Review medical records and finalize data entry for medical records loaded into q.Metrics and supplemental databases that substantiate HEDIS/Star compliance.
• Assists in collaboration for process development to increase member compliance with HEDIS/Star measures.
• Use excellent customer service skills to contact members by phone, text, email and mail in efforts to educate and assist members with completing HEDIS/Star measures.
• Prepare for three-month auditing period with Health Plan insurance and CMS.
• Review annual updates on HEDIS/Star measures and act as a resource for NCQA standards.
• 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.
• Knowledge of quality metrics preferred.
• Arizona Medical Assistant certification required.
• Minimum 1.5 years' experience in healthcare or managed care setting with responsibility for systems and/or projects.
• Knowledge of qHMO and NextGen preferred.
• Excellent interpersonal communication skills.
• Ability to work independently once oriented to routine and process.
• Ability to find, gather and collect information or data.
• 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.*