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Medicare Clinical Quality Consultant- RN in Jacksonville, FL at Integrated Resources, Inc

Date Posted: 12/7/2018

Job Snapshot

Job Description

Job Description: This position is accountable for supporting Primary Care Practices to improve patient health outcomes for their Client Medicare population. The requirements for this position include: 1) Assisting the providers in delivering improved patient care and decrease in hospital readmissions and misuse of emergency visits. 2) Enhance traditional case management programs by physically and geographically integrating nurses into the local provider community. 3) Support the POD case management delivery system through assuring timely PCP follow-up and compliance with treatment plans for members with chronic conditions. 4) Educate the provider community on impact of CAHPS, HOS and HEDIS on member outcomes and STARs performance. 5) Assess provider office practices for opportunities for improvement to positively impact member experience and impact CAHPS and HOS ratings. This position will be required to communicate and collaborate with Value Based and non-valued based partners as well as other stakeholders to effectively manage the delivery of strategies, plans and improvements to HEDIS, Medicare Stars, Qualified Health Plans/Quality Rating Systems and other clinical quality measurements. Knowledge and utilization of health analytic tools is required to identify opportunities to improve satisfaction and quality. (See Attached Document for more Functions, etc.)
Comments for Suppliers: This position will be for Hillsborough, Pinellas, Manatee, Hernando & Pasco Counties.

They will be traveling 4 days a week on the road with 1 administrative day. They will be travelling between provider offices in the counties listed above.