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Job Details

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About This Employer


Connecting employers with the talent they need + connecting healthcare professionals with the jobs they’ll love

Headquartered in New York City with 9 additional offices in New York, New Jersey, Connecticut, Massachusetts, and Florida, The Execu|Search Group specializes in the placement of healthcare professionals in full-time and temporary roles. From Registered Nursing positions to Medical Directors and Hospital Administrators, we work with some of the best healthcare facilities and are focused on connecting candidates with jobs that are tailored to their unique qualifications.  Our Health Services recruiters have achieved the Gold Seal of Approval™ for healthcare staffing services from The Joint Commission, which recognizes our dedication to providing our clients with qualified healthcare professionals.


The Execu|Search Group

CITY :

JACKSONVILLE

STATE :

FL

COUNTRY :

USA

ZIP CODE :

32099

JOB ID NUMBER :

J137523

POSTED :

01/30/2017

Quality Practice Advisor


The Execu|Search Group


POSITION TYPE:  Full-Time

JOB SUMMARY:


Quality Practice Advisor
Quality Practice Advisor
Location: Jacksonville, FL
Salary: $60,000-$85,000
Experience: 2.0 year(s)
Job Type: Full-Time
Job ID: J137523
 
   
About the Opportunity

An established managed care company in Jacksonville, FL is actively seeking a self-motivated and dynamic individual for a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor establishes and fosters a healthy working relationship between large physician practices, IPAs and the company. Apply today!

Company Description

Managed Care Company

Job Description

The Quality Practice Advisor:

  • Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements
  • Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement
  • Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters)
  • Delivers provider specific metrics and coach providers on gap closing opportunities
  • Identifies specific practice needs where the company can provide support
  • Develops, enhances and maintains provider clinical relationship across product lines
  • Defines gaps in the company's service relationship with providers and facilitate resolution
  • Leads and/or supports collaborative business partnerships
  • Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education
Required Skills
  • Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field
  • One of the following: Certified Coding Specialist (CCS), LPN, LCSW, LMHC, LMSW, LMFT,  LVN, RN, NP, record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff
  • 3+ years of directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement
  • 1+ year of experience in Managed Care 
  • 3 + years of directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement
  • 2+ years of experience in directly related HEDIS medical
  • Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Desired Skills
  • Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field