What are the responsibilities and job description for the Coord. Payor Performance position at University Medical Center of El Paso?
Job Summary
The Payor Performance Coordinator is responsible for identifying opportunities for improvement providing staff education on the health plan’s STAR initiatives, to include HEDIS and CAHPS and HOS surveys as it relates to improving member experience and health outcomes. Utilizes health analytic tools to identify trends and opportunities to enhance the health of patients and support providers with management of their patients. Communicates 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, Medicaid MCO performance, Qualified Health Plans/Quality Rating Systems and other clinical quality measurements.
Minimum Job Requirements:
Work Experience:
Two years of experience in Managed Care required. Experience with HEDIS, STAR, CAHPS, CMS and HOS required.
License/Registration/Certification:
None.
Education and Training:
High School diploma or equivalent required. Associate’s degree in related field preferred (i.e. Healthcare, Business).
Skills:
- Knowledge of HEDIS/Stars/CMS/Quality preferred.
- Experience with healthcare quality improvement strategies.
- Experience or working knowledge of HEDIS, Stars and the Qualified Health Plan/Quality Rating System.
- Ability to interact with medical staff, peers, and internal company staff at all levels.
- Ability to work non-traditional working hours to meet the health plan’s availability.
- Intermediate health care data management and project management skills.
- Experience in MS Word, Excel, PowerPoint, tablet and/or smartphone.
- Travel up to 20% (subject to change) for on-site heath plan/provider meetings, events or manager requests.
- Experience with improving member satisfaction and health outcomes.
- Working knowledge with health insurance and managed care.
