Quality Measures Specialist

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

500 E Central Ave

City:

Winter Haven

State:

Florida

Postal Code:

33880

Job Description:

• Reviews ambulatory clinical documentation to ensure accurate depiction of patient acuity, including compliant documentation supporting HCC, ICD-10, and medical necessity.
• Demonstrates knowledge of CMS coding guidelines to improve the overall quality and completeness of patient medical records.
• Pulls data from multiple sources to produce reports related to ambulatory clinical documentation, quality, and value-based care.
• Collaborates with quality and multidisciplinary teams to develop strategies for improving clinical documentation quality and patient risk adjustment.
• Communicates professionally and respectfully with providers, practice staff, quality leaders, medical directors, and compliance specialists.
• Leads and collaborates on special projects around quality metrics with medical directors, leadership, practices, and stakeholders.
• Provides education to providers and staff regarding value-based care and the importance of accurate, specific, and complete clinical documentation.
• Participates in meetings, committees, and educational programs as needed. Performs other duties as assigned.

Knowledge, Skills, and Abilities:

• Knowledge of chronic and acute disease conditions, management, and treatment [Required]
• Knowledge of value-based care [Required]
• Understanding of care gap closure and value-based care [Required]
• Understanding of Healthcare and clinical operations, medical terminology, and medical reporting [Required]
• Ability to communicate effectively with providers [Required]
• Capacity to collaborate with professional colleagues as necessary to ensure quality care [Required]
• Able to interpret, adapt and apply guidelines and procedures. [Required]
• Excellent communication skills; both verbal and written [Required]
• Outstanding organizational skills [Required]
• Solid problem-solving skills, identifying, analyzing and effectively solving problems, utilizing critical thinking [Required]
• Capability to multitask [Required]
• Able to work independently. [Required]
• Ability to work in multiple systems, extract data and create reports. [Required]
• Adaptability and flexibility, able to function in a fast-paced environment. [Required]
• Strong computer skills including previous experience with an EMR and Microsoft Office, and reporting software. [Required]
• Knowledge of data analysis and statistical methods [Preferred]
• Comprehensive knowledge of value-based care [Preferred]
• Expertise in coding and documentation [Preferred]

Work Experience:

• 3+ equivalent experience in healthcare system or medical practice [Required]

Licenses and Certifications:

• Certified Billing and Coding Specialist (CBCS) [Required]
• American Association Medical Assistants (CMA) [Required] OR Clinical Medical Assistant Certification (CMAC) [Required] OR Registered Medical Assistant (RMA) [Required] OR National Certified Medical Assistant (NCMA) [Required] OR Certified Clinical Medical Assistant (CCMA) [Required] OR Nationally Registered Certified Medical Assistant (NRCMA) [Required]
• Certified Research Coordinator (CRC) [Required] OR Certified Professional Coder (CPC) [Required] OR Certified Outpatient Coder (COC) [Required] OR Licensed Practical Nurse (LPN) [Required]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$20.23 - $98,136.64

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.