This position has a potential to work from home once training / orientation is completed and strong performance is maintained.
This position requires you to be in the field traveling to different provider offices on a daily basis.
The Clinical Quality Consultant will drive consistency, efficient processes and share best practices – in a collaborative effort with the providers – designed to facilitate a minimum 4 STAR rating. The CQC will participate in quality improvement initiatives, develop recommendations for quality remediation plans and create tools and databases to capture relevant data for each region. This position will work collaboratively with each regional / market team and their leadership in a matrix relationship.
- Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher
- Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups
- Be the primary go to person for all STARS related activities within their assigned market(s) working within a matrix relationship which includes Quality corporate operations and Regional / Market operations
- Assist in developing of training and analytical materials for Stars and HEDIS
- Lead Weekly, Monthly, Bi-monthly, Quarterly and / or Annual business Review meetings related to STAR activities which summarize provider group performance and market performance as requested by or required by Quality or Regional leadership
- Analyze and evaluate provider group structure and characteristics, provider group / provider office operations and personnel to identify the most effective approaches and strategies
- Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes
- Focus communications and efforts accordingly
- Develop solution-based, user friendly initiatives to support practice success