ACO Quality Improvement Nurse
Location: Springfield Massachusetts
Description: Accountable Care Associates is currently seeking to employ ACO Quality Improvement Nurse right now, this vacancy will be placed in Massachusetts. More details about this vacancy opportunity please give attention to these descriptions. GENERAL JOB SUMMARY
This position is responsible to review and monitor performance data generated by provider practices that participate in! the ACO program to assure compliance with requirements of regulatory agencies and third-party payers. Will work collaboratively with the Quality team and provider offices to manage interventions aimed at increasing compliance with quality measures. Works with provider partners around performance improvement measures essential to the ACO program. Travels to provider sites as needed for team meetings or chart reviews. Serves as a resource and subject matter expert on aspects of the quality program to develop and influence business strategies.
ESSENTIAL JOB FUNCTIONS
Responsible for the ongoing review of data entry and management to assure reports can be generated to meet expected timelines.
Communicate effectively both verbally and in writing.
Assumes responsibility for follow-up on problems or questions related to data entry and management in Carescreen â„¢
Ability to think strategically, analyze issues and develop recommendation! s
Developing and managing cross-functional business p! artner relationships
Performs needed activities to meet requirements of the ACO program, including managing appeal process and report writing.
Serves as a clinical resource to provider practices to develop strategies to meet quality measures.
Work on other quality programs as necessary.
EDUCATION AND EXPERIENCE
AD or Bachelor̢۪s Degree in Nursing or related health care field.
Registered Nurse required.
Managed Healthcare professional is required
Quality Management 2-3 years
Preferred knowledge of HEDIS, CAHPS and NCQA
Intermediate to advanced Microsoft computer skills. \
Abou t Accoutable Care Associates:
Accountable Care Associates is an innovative MCO healthcare management services organization, developer and vendor of nationally recognized best-in-class proprietary IT, data, infrastructure, and management solutions for healthcare providers, institutions, payors,! and others in the healthcare industry. ACA provides services and infrastructure solutions, including managing and partnering on global risk contracts and ACO model structures.
ACA offers data warehouse, data analytics, quality metrics, reporting, risk adjustment, and compliance support services. ACA̢۪s team manages Medicare programs, case management services, disease management services, Blue Cross Blue Shield AQC, and other commercial programs. Under the guidance of founder and chairman, Dr. Phil Gaziano, the ACA leadership team has developed managed care infrastructure, including case management, complex disease management, coding, data analytics, and dedicated hospital rounding programs.
ACA continues to develop and provide innovative, leading-edge, services in global capitation programs and the organization was one of the first in its home state of Massachusetts to become delegated to do its own complex disease management. Quality, efficiency, and me! mber satisfaction measures have continued to improve, and enrollment in! global capitation ACO-type programs have continued to grow based on ACA's proven track record of performance and success for partners and clients.
Summary Benefit Program :
PAID TIME OFF (PTO) AND HOLIDAYS: 18 days per year and 10 holidays per year
HEALTH INSURANCE: We currently offer Blue Cross/Blue Shield HMO Blue Value NE and a PPO plan. This pre-tax deduction can be arranged for you individually or for the whole family.
DENTAL INSURANCE: We currently offer Dental Blue for individual or family coverage.
VISION INSURANCE: Vision insurance is offered through VSP with a 4 tier program of coverage.
LIFE INSURANCE & ACCIDENTAL DEATH & DISMEMBERMENT: This is totally free of charge for you! The insurance plan has a value equal to your annual salary, so as your salary increases so does the value of your life insurance. You may also choose to purchase additional insurance coverage for you ! and your dependents. (maximums amounts do apply)
ADDITIONAL ANCILARY BENEFITS â€" Accountable Care will also provide employees with a means to purchase at group rates for additional life, dependent life, short term disability and cancer insurance, just to name a few options.
SHORT TERM DISABILITY: STD is offer at no charge to our employees scheduled 32 hours or more. Should you become sick or disable you would receive 60% of your pre-disability income (some restrictions do apply)
LONG TERM DISABILITY: LTD is offered at no charge to our employees scheduled 32 hours or more. Should you become sick or disabled you would receive 60% of your gross monthly income (some restrictions do apply).
401(k) RETIREMENT SAVINGS PLAN: Allows you to save money and plan for retirement through pre-tax payroll deductions after one year of service. Company contribution after 12 consecutive months of employment. Enrollment allowed the first! quarter after your first year of employment.
FLEXIBLE SPEN! DING ACCOUNTS (Dependent Care and Health Care): By opening a heath care or dependent care spending account, you may reimburse yourself for medical and/or dependent care expenses on a tax-favored basis, with dollars that are not subject to federal, state, and social security taxes.
PARKING DISCOUNT: ACA pays the majority of the cost for parking at several nearby garages at Monarch Place. The employee cost is currently $9.23 per bi-weekly pay period.
EMPLOYEE REFFERAL PROGRAM: Up to $1,000 for exempt positions, $500 for non-exempt (hourly) positions. (some restrictions do apply).
EMPLOYEE ASSISTANCE PROGRAM: Confidential free service designed to assist you or your family members with financial concerns, legal questions, behavioral issues, substance abuse and work related problems. Counselors are available 24/7 365 days a year.
Please send resumes to:
careers@acafirst.com
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If you were eligi! ble to this vacancy, please email us your resume, with salary requirements and a resume to Accountable Care Associates.
If you interested on this vacancy just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Fri, 04 Oct 2013 16:23:42 GMT