Job Description

Our Mission:  Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.

Our Vision: 

Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.

Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!

  Position Purpose:  The Performance Improvement Coordinator works in collaboration with physician practices to execute on opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance.

Responsibilities:

  • Works in collaboration with physician practices to target opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance
  • Maintains collaborative team relationships with peers, colleagues, and physician practices in order to effectively and efficiently achieve goals and foster a positive work environment
  • Supports process improvement to enhance physician and staff workflow and drive performance improvement
  • Supports medical record data review/collection as it relates to performance improvement goals for risk adjustment and quality management purposes, including contractual obligations
  • Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment and Quality performance measures, like HEDIS
  • Interacts with providers regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Coordinates and communicates with local Health Plan management to track and share data with practices on performance against goals, escalating issues at the practice level in a timely manner
  • Works collaboratively with assigned practices staff, including Performance/Quality staff and Office Managers to coordinate improvement efforts 
  • Implements performance improvement plans at the practice level and support monitoring and evaluation of performance by following policies and procedures for tracker data entry and maintenance
  • Produces and maintains record by keeping documentation updated real-time and reporting progress on a weekly basis
  • Provides dashboard reports to providers and practices with recommendations on improvement, establishing and implementing accountability for performance improvement
  • Educates providers and leadership on clinical indicators to capture the severity of illness of the patient
  • Assists in preparation of training materials (Provider and Practice-facing)
  • Provides leadership and staff with training, on-site collaboration and on-going performance reporting
  • Valid Arizona Driver’s License

Education / Experience / Other Requirements

Education: Medical Assistant or LPN license preferred, or equivalent clinical experience

 Specialized Knowledge:

  • Knowledge of quality metrics and risk adjustment preferred

   Skills & Abilities:

  • Ability to demonstrate excellence and set high standards of performance for self and all coworkers, including delivering high-quality work and results
  • Ability to project manage, organize, and effectively plan to support working on multiple and competing priorities, including paying appropriate attention to details
  • Ability to work independently and manage time well
  • Ability to organize and prepare training materials, conduct in-person and computer-based training
  • Ability to maintain stable performance and poise under pressure and demonstrate a strong sense of diplomacy and professionalism
  • Ability to demonstrate effective verbal communication one to one, in small groups and in public-speaking (training) contexts, including the ability to articulate areas of areas of opportunity to providers and practices as well as health plan leadership
  • Ability to demonstrate effective written communications by writing clear, precise, well-organized emails and other written correspondence
  • Ability to use technology effectively and proficiently including basic Microsoft Office product
  • Required to attend meetings as necessary; some will offer virtual attendance while some will require in-person attendance at the local Health Plan office

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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