Primary Responsibilities
Quality Data Abstraction & Reporting
- Collect, abstract, and validate clinical and operational quality data across all joint ventures, ensuring accuracy and completeness for internal and external reporting.
- Maintain and update quality scorecards, performance dashboards, and tracking tools on a regular basis to reflect current performance across the JV portfolio.
- Generate recurring and ad hoc quality performance reports for the Quality Program Supervisor, joint venture leadership, and physician partners.
- Support accurate documentation and submission of quality and cost performance data in compliance with CMS, MSSP, ACO, and other value-based care program requirements.
Performance Monitoring & Gap Analysis
- Monitor quality metrics and performance benchmarks across all joint ventures, flagging variances, trends, and care gaps for supervisor review and action.
- Analyze data to identify root causes of quality score variances and support the development of targeted performance improvement initiatives.
- Track care gap closure activities across joint ventures, coordinating with clinical staff and physician offices to ensure timely completion and documentation.
- Support the preparation of performance summaries and trend analyses to inform physician engagement and leadership decision-making.
Care Coordination Support
- Assist in coordinating care gap closure workflows between hospital and physician group partners, helping to reduce service duplication and improve care transitions.
- Support outreach efforts to patients and care teams to facilitate completion of outstanding quality measures and preventive care activities.
- Maintain organized records of care coordination activities, follow-up actions, and outcomes across joint venture entities.
Meeting Coordination & Administrative Support
- Coordinate and prepare materials for quality meetings, performance reviews, and joint venture leadership presentations, including agendas, data summaries, and follow-up action items.
- Maintain organized documentation of meeting minutes, governance decisions, performance records, and compliance activities across the JV portfolio.
- Support the onboarding of new joint venture programs by assisting with data setup, reporting infrastructure, and workflow integration.
Compliance & Audit Support
- Assist in maintaining audit-ready documentation for regulatory and payer reviews, ensuring quality and performance records are complete and accessible.
- Support the development of Plans of Correction (POC) by compiling data, tracking corrective action progress, and documenting outcomes.
- Ensure data abstraction and reporting activities align with HIPAA privacy standards, CMS program requirements, and joint venture governance policies.
Qualifications
Education:
Preferred: Associate’s or Bachelor’s degree in Health Information Management, Healthcare Administration, Nursing, or a related field. Preferred: Bachelor’s degree in a healthcare or data-related discipline.
Experience:
1–3 years of experience in healthcare quality, data abstraction, performance reporting, or a related role. Experience in an ACO, value-based care, or joint venture environment is a plus. Familiarity with CMS quality programs, Stars measures, or risk adjustment preferred.
Technical Skills:
- Proficiency in Electronic Health Records (EHR) systems and quality reporting tools.
- Experience with data visualization or reporting platforms such as PowerBI, Tableau, or Excel.
- Strong attention to detail with demonstrated ability to manage and validate large data sets accurately.
Knowledge Areas:
- Working knowledge of CMS regulations, value-based payment models, and quality reporting requirements.
- Familiarity with Stars quality measures and care gap closure processes.
- Understanding of HIPAA privacy standards and healthcare data governance practices.
Scope & Impact
- Supports quality performance across all joint ventures within the Deaconess Health System portfolio.
- Contributes directly to CMS Star Ratings, shared savings performance, and regulatory compliance through accurate and timely data support.
- Reports to the Quality Program Supervisor of Joint Ventures; collaborates with physicians, clinical staff, and operational leaders across joint venture entities.
- Plays a key role in building scalable, standardized quality infrastructure to support the continued growth of the JV portfolio.