The Program Coordinator is responsible for coordinating all aspects of the CMS 5 Star and P4P requirements as delegated by the plans to the group. The coordinator will develop strategies to maximize performance in the clinical metrics through coordination of efforts with physician offices and members. The coordinator will serve as the project lead and report on program progress to management. The position requires the ability to multi-task, strong communication skills, deadline oriented, and excellent follow-up skills.
- Review data reports as provided by plan(s) and data vendor and identify discrepant patient information.
- Communicate discrepant patient information to plan(s) and continually follow up with issue until corrections are made.
- Collaborate with Intelligent Healthcare to ensure data report issues are resolved for all groups.
- Follow up with providers to obtain updated medical information for patients and maintain the data administratively.
- Develop clinical initiatives/tools to address clinical metrics where group is underperforming.
- Perform member outreach to ensure members are getting their diagnostic screenings and preventive exams completed.
- Coordinate with physician offices to set up program events aimed at maximizing patient compliance.
- Assist in providing content to provider newsletter and fax blast.
- Provide in-services to physician offices regarding 5 Stars/ P4P program requirements.
- Participate in committee meetings and oversight of Senior Advisory Board.
- Prepare reports (analysis/trending) and/or present on program progress to committee and management.
- Plan and participate in provider, office staff, peer to peer training sessions on quality measures.
- Promote awareness of 5 Star/P4P programs to staff, physician offices, and all appropriate personnel.
- Be knowledgeable of changes to 5 Star/P4P program requirements and inform committee and physician offices.
- Coordinate health education events related to Stars/P4P measures.
- Assist with registration/audit follow up process for P4P program.
- Perform special projects as needed.
- Minimum 2+ years of healthcare experience
- Bachelor’s Degree preferred
- Ability to work and manipulate data for analysis
- Strong computer skills (Microsoft Office programs)
- Detail oriented and deadline conscious
- Strong communication skills (written/verbal)
- Intermediate quantitative analysis skills
- Team player and strategic thinker
- Strong understanding of managed care
- Creative problem solver
- Works well with senior patients
- Ability to travel locally
MWWJob: Non-Clinical/AdministrativePrimary Location: Lakewood, CaliforniaHospital Location: Coast HealthcareJob Type: Full-timeShift Type: Days Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.
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