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