Clinical Quality Improvement Coordinator – Eye Exam Specialist

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🔥 4 minutes ago

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Guide Healthcare

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

🏥 Healthcare

🎯 Recruiter

Healthcare Insurance • Healthcare • Recruitment

Guide Healthcare is leading a movement where creativity delivers positive change in the healthcare sector. The company specializes in allied health service provision and healthcare recruitment, focusing on the support and treatment of older adults. With a commitment to adding value to their clients, partners, and teams, Guide Healthcare aims to do things differently in the industry.

📋 Description

• Working in a field-based role, traveling to provider practices and patient homes for scheduled eye exam appointments, while engaging virtually with team members, internal partners, customers, providers, payers, and care teams on non-appointment days. • Serving as a subject matter resource across Medicare Advantage STAR, Commercial, Medicaid, and MSSP ACO quality measures, services, customers, and quality improvement initiatives under commercial and governmental payer programs. • Traveling to provider practices and patient homes on a scheduled appointment basis to perform diabetic eye exams (retinal screenings) using company-provided imaging equipment and supporting the closure of eye exam and related quality gaps. • Conducting proactive patient outreach on days without scheduled eye exam appointments to identify and address quality gaps across Medicare Advantage, Commercial, Medicaid, and MSSP populations. • Educating patients on preventive care measures, assisting with scheduling necessary screenings or appointments, and supporting adherence to treatment plans and medications to improve health outcomes. • Supporting ACO quality reporting and performance improvement activities, including MSSP reporting requirements and payer-specific submissions. • Collecting, reviewing, and abstracting quality data using multiple data sources, including EMR systems, claims data, provider outreach, payer portals, medical records, patient engagement workflows, and internal applications. • Communicating quality performance trends, barriers, and improvement strategies internally and, as appropriate, with customers, providers, payers, and care teams.

🎯 Requirements

• Willingness and ability to travel daily, up to 100%, to provider practices and patient homes to perform scheduled eye exams; no prior eye exam or imaging experience required, as full training and equipment are provided by the company. • Must have a valid driver’s license and reliable transportation. • Associate degree or greater in a related field. • Minimum of 1–3 years of experience in a healthcare setting. • Minimum of 2 years of experience supporting Medicare Advantage, Commercial, Medicaid, or MSSP quality programs, including data abstraction and patient outreach. • Experience working with EMR systems, medical records, health data, chart review, or data abstraction workflows. • Knowledge of medical terminology, quality measures, medical billing, or coding. • Proficiency using Microsoft Excel, PowerPoint, Word, Outlook, Teams, and multiple healthcare-related systems or applications. • Strong verbal and written communication skills. • Strong attention to detail, organizational skills, and ability to meet hard deadlines. • Ability to collaborate effectively with management, co-workers, customers, providers, payers, and care teams. • Ability to work independently in a remote environment.

🏖️ Benefits

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs. • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered. • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution. • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected. • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times. • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals. • Support Your New Family: Guidehealth offers paid parental leave to give you the time you need. • Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

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