Quality Tracker I (69281)

“Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness.”

Job Summary

Quality trackers assist and provide information related to the clinical quality process. They make sure companies follow compliance requirements based on the payer contract. They improve processes, assist with supplemental data, and generate reports and document QA systems. They might also train other team members in quality assurance. A Quality Tracker follows all the Sanitas measures of processes, experiences and/or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patient-centered, equitable, and timely care. Trackers provides comprehensive reporting and analytics at population, provider, and patient level. Our solution allows a health plan to track performance measurement of quality measures across Commercial, Medicare, and Medicaid lines of business including HEDIS, STARs, and state-specific Medicaid measures. The Quality Tracker provides robust solutions to help overcome challenges associated with HEDIS compliance based on benchmark across – providers, practices, organizations, etc.

Essential Job Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Proactive and continuous monitoring of quality measures including HEDIS and Medicare STARs.
• Identification and tracking of quality gaps across time. Comprehensive analytics for tracking trends by measure. HEDIS measure tracking, reporting, and submission.
• Help with medical records requests.
• Request test results. Assist obtaining reports and upload the test in the patient chart. Assistant with supplemental data. Training other groups about quality measures and best practices.
• Proactive participation in the closure of the quality HEDIS/START metric.
• Review the quality metric, identify the action needed to close it. If required, place the standing order, assist in the referral process, communicate with the patient to notify them of the action, and schedule an appointment.
• Proactive participation in patient outreach.
• The quality tracker should support patient outreach and appointment assignment.
• Education to the essential team including providers, CCA, pre-visit team and others.
• The quality tracker should be able to educate about all the NCQA quality metrics inclusions and share that information with the required personnel. Education sessions could be scheduled on-site in the centers, corporate office, or virtually.