AtlantiCare Regional Medical CenterAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Description POSITION SUMMARYThe Quality Reviewer is responsible for overseeing quality reporting processes to payers, including in-office assessments (IOAs). This position involves attending regular meetings with payers to review data and identify opportunities for improvement. Responsibilities include collecting and analyzing health data to identify trends and gaps in care, ensuring compliance with regulations such as HEDIS and CMS guidelines, and providing feedback to healthcare practices to enhance quality outcomes. Additionally, the role involves tracking performance by chart auditing clinical staff, metrics related to population health initiatives and reporting findings to leadership.
This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to teamwork and cooperation.
QUALIFICATIONSEDUCATION: High school diploma or equivalent, minimum 3 years' experience required within an ambulatory care setting required, certified Medical Assistant preferred
LICENSE/CERTIFICATION: Valid driver's license required.
EXPERIENCE: Minimum 3 years experience required within an ambulatory care setting required.
PERFORMANCE EXPECTATIONSDemonstrates the competencies as listed on the Assessment and Evaluation Tool.
WORK ENVIRONMENTEssential functions of this position are listed on the Assessment and Evaluation Tool
REPORTING RELATIONSHIPThis position reports to department leadership.
The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.Total Rewards at AtlantiCareAt AtlantiCare, we believe in supporting the whole person. Our market-competitive Total Rewards package is designed to promote the physical, emotional, social, and financial well-being of our team members. We offer a comprehensive suite of benefits and resources, including:
Generous Paid Time Off (PTO)Medical, Prescription Drug, Dental & Vision InsuranceRetirement Plans with employer contributions
Short-Term & Long-Term Disability CoverageLife & Accidental Death & Dismemberment InsuranceTuition Reimbursement to support your educational goals
Flexible Spending Accounts (FSAs) for healthcare and dependent care
Wellness Programs to help you thrive
Voluntary Benefits, including Pet Insurance and more
Benefits offerings may vary based on position and are subject to eligibility requirements.
Join a team that values your well-being and invests in your future.
Job Category Administration
Hours Per Week 40
Weekends Required? No
Holidays Required? No
ShiftDays
Posititon StatusFull-Time
Job Details Pay Range $17.88 - $25.95
Pay Transparency In order to support the Fair Compensation Strategy by the US Govt., HR Dept., clients are required to adhere to Pay Transparency Law; in the impacted states; that have mandated the employers to list the salary ranges in Job advertisements or postings for job opportunities and Job promotions.
PI280491598
