Quality Analyst

Company: St. Luke's University Health Network
Location: Allentown
Posted on: January 12, 2021

Job Description:

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.The Quality Analyst will work closely with Revenue Enhancement analysts, Care Coordinators, and the practice administrator. He/she will be a resource for Quality/Pay-for-Value programs with the intent of increasing revenue associated with these programs. He/she will assist the providers and practice staff members to remain compliant with each plan. The intent of this job description is to provide a summary of the major duties and responsibilities of this position and shall not be considered a detailed description of all the work requirements that may be included in this position.JOB DUTIES AND RESPONSIBILITIES: ESSENTIAL FUNCTIONS:Assists in monitoring and/or scheduling primary care visits. Demonstrates proficiency in participating insurances' quality programs in order to appropriately outreach based on payer specifications. Addresses outstanding gaps in care identified by standard payer reports for optimal preventive care and general chronic disease management. Accesses and/or may enter data into clinical systems including EHR and various payer platforms. Adheres to authorized standing orders when entering electronic orders in the EHR system as appropriate. Exhibits understanding of practice workflows to optimally identify site-level opportunities for process improvement that could bolster quality scores. Assists with review of findings and suggestions for improvement with care team members. Aid in the promotion of Quality programs and medical home goals. Maintains confidentiality of all materials handled within the Network/ Entity as well as the proper release of information. Complies with Network and departmental policies regarding issues of employee, patient and environmental safety and follows appropriate reporting requirements. Demonstrates/models the Network's Service Excellence Standards of Performance in interactions with all customers (internal and external). Demonstrates Performance Improvement in the following areas as appropriate: Clinical Care/Outcomes, Customer/Service Improvement, Operational System/Process, and Safety. Demonstrates financial responsibility and accountability through the effective and efficient use of resources in daily procedures, processes and practices. Complies with Network and departmental policies regarding attendance and dress code. Demonstrates competency in the assessment, range of treatment, knowledge of growth and development and communication appropriate to the age of the patient treated.OTHER FUNCTIONS:Other related duties as assigned. PHYSICIAL AND SENSORY REQUIREMENTS:Requires sitting, standing and walking for extended periods of time (up to 8 hours at time). Requires continual use of fingers for patient care, writing and computer entry. Routinely uses upper extremities; occasional requirement to lift up to 25 pounds. Occasionally push cart with supplies up to 30 pounds. Occasionally push wheelchair with patient weighing up to 325 pounds. Regularly requires ability to stoop, bend and reach above shoulder level. Requires ability to hear normal conversation and good general, near and peripheral vision. POTENTIAL ON-THE-JOB RISKS:No identified risks.SPECIFIC PROTECTIVE EQUIPMENT AVAILABLE:NoneMOST COMPLEX DUTY:This position requires the ability to work under pressure with a diverse population.SUPERVISION (RECEIVED BY AND/OR GIVEN TO):Quality Recognition Programs ManagerCOMMUNICATIONS:This position interfaces with the practice's health care team as well as the patient, the patient's family, insurance companies and other members of the health care profession. Excellent verbal and written skills are required.QUALIFICATIONS)(MINIMUM)EDUCATION:High School graduate or equivalent. Preference given to candidates with accredited medical assistant/administrative training or Associates degree in relevant field. TRAINING AND EXPERIENCE:A minimum of three years working with managed care plans in a physician setting is required. Knowledge of medical terminology, general documentation guidelines and knowledge of physician reimbursements required. Knowledge of provider enrollment procedures is helpful. Technically competent in MS Office applications (Word, Excel, Power Point, and Outlook), EHR, and practice management systems, and willing to learn new internal systems and tools. WORK SCHEDULEDays, evenings, and weekends as assignedPlease complete your application using your full legal name and--current home address. Be sure to--include--employment history for--the past seven (7) years, including your present employer. Additionally, you are--encouraged to upload a current resume, including all work history, education, and/or certifications and--licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!St. Luke's University Health Network is an Equal Opportunity Employer.

Keywords: St. Luke's University Health Network, Allentown , Quality Analyst, Professions , Allentown, Pennsylvania