Job description
Position Description:
The Quality and Utilization Support Specialist provides a broad range of clerical and technical support for Quality and Utilization.
Performance Responsibilities and Standards:
- Provides a wide range of administrative support-related tasks
- Provide assistance with DVA Audit and HEDIS preparation
- Oversee the MAC meetings, including preparation, agenda, minutes
- Coordinate regular pharmacy meetings, and assist with follow up
- Assist with data analysis for the DSNP and MLTC
- Manage communications from CMS
- Coordinate UM Committee Meetings, provide minutes
- Monitor and coordinate follow up meetings for Critical Events, Falls
- Responsible for assisting with reporting requirements for Utilization Review and Quality
- Demonstrate effective interpersonal skills, exercising good judgment in a variety of situations
- Demonstrate critical thinking and common sense resolution.
- Meet routine deadlines and work schedules with accurate completion of work.
Other expectations:
a. Provides excellent customer service.
b. Maintains client confidentiality.
c. Maintains positive relationships with co-workers, administrative staff, clinical staff,
families and other entities.
d. Perform all other duties as assigned.
Requirements:
- High School Diploma or equivalent required. College degree preferred.
- Minimum of one year customer service experience required, preferably in a health care setting.
- Proficiency with computer systems, working knowledge of Microsoft Office, Excel, Power Point, Internet and various software applications.
- Demonstrate ability to work independently and collaboratively with ability to adapt to shifting priorities, demands, and timelines.
- Demonstrates discretion in handling confidential and sensitive information
- Excellent verbal and written communication skills
- Exceptional customer service skills required.
- Accuracy and attention to details and follow through
- Excellent organizational skills, including proficiency in Microsoft Office software including Word, Excel, and PowerPoint
Physical Requirements:
- Speech/visual/hearing ability sufficient to comprehend and express written and verbal communications.
- Ability to sit or stand 90% of the day.
- Bloodborne Pathogens Exposure Category III - Employee who rarely has contact with blood and body fluids.
Compensation & Benefits:
Competitive Salary with:
- 401K with generous Employer match
- Medical, Dental, Vision plans
- Tuition Reimbursement for BSN after 6 months of employment
- Paid Mileage/Fleet Vehicle
- Exceptional work/life balance - no rotating shifts
- Employee Recognition Platform
- Partially funded HSA
- Paid Time Off and Extended Sick Leave
- Short/Long term Disability
- Employee Assistance Program (EAP)
- Much More!!
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About Nascentia Health:
Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.
Our employees are our greatest asset. They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve. We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.
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Nascentia Health is an Equal Opportunity Employer (EOE)
Employment is contingent upon negative results of a pre-hire drug screen
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