American Health Communities
Medicare Advantage Quality Coordinator
American Health Communities, Franklin, Tennessee, us, 37068
American Health Partners
201 Jordan Rd
Franklin, TN 37067, USA
The Medicare Advantage (ISNP) Quality Coordinator supports quality improvement initiatives for Institutional Special Needs Plans (ISNP). This role ensures compliance with CMS quality standards, assists with data collection and reporting, and collaborates with internal teams to improve health outcomes and member experience. The position focuses on monitoring performance metrics, supporting audits, and driving continuous improvement in quality programs.
ESSENTIAL JOB DUTIES
Monitor and track ISNP quality performance measures, including HEDIS and Star Ratings.
Assist in the development and implementation of quality improvement projects and initiatives.
Collect, validate, and analyze data to identify trends and opportunities for improvement.
Support compliance with CMS regulations and organizational policies related to ISNP quality programs.
Prepare reports and presentations for internal stakeholders and leadership.
Collaborate with clinical, operational, and compliance teams to ensure alignment on quality goals.
Participate in audits and readiness reviews, providing documentation and responding to inquiries.
Maintain accurate records and documentation for quality activities.
Other duties as assigned.
REQUIRED QUALIFICATIONS
Education:
Bachelor’s degree in healthcare administration, nursing, public health, or related field (or equivalent experience).
Experience:
2+ years of experience in long-term care, Medicare Advantage, quality improvement, or managed care.
Familiarity with CMS regulations, HEDIS measures, and Star Ratings.
REQUIRED KNOWLEDGE / SKILLS
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
Ability to manage multiple priorities and meet deadlines.
PREFERRED QUALIFICATIONS
Experience with ISNP programs or long-term care settings.
Knowledge of quality reporting tools and data analysis software.
Certification in healthcare quality (e.g., CPHQ) is a plus.
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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The Medicare Advantage (ISNP) Quality Coordinator supports quality improvement initiatives for Institutional Special Needs Plans (ISNP). This role ensures compliance with CMS quality standards, assists with data collection and reporting, and collaborates with internal teams to improve health outcomes and member experience. The position focuses on monitoring performance metrics, supporting audits, and driving continuous improvement in quality programs.
ESSENTIAL JOB DUTIES
Monitor and track ISNP quality performance measures, including HEDIS and Star Ratings.
Assist in the development and implementation of quality improvement projects and initiatives.
Collect, validate, and analyze data to identify trends and opportunities for improvement.
Support compliance with CMS regulations and organizational policies related to ISNP quality programs.
Prepare reports and presentations for internal stakeholders and leadership.
Collaborate with clinical, operational, and compliance teams to ensure alignment on quality goals.
Participate in audits and readiness reviews, providing documentation and responding to inquiries.
Maintain accurate records and documentation for quality activities.
Other duties as assigned.
REQUIRED QUALIFICATIONS
Education:
Bachelor’s degree in healthcare administration, nursing, public health, or related field (or equivalent experience).
Experience:
2+ years of experience in long-term care, Medicare Advantage, quality improvement, or managed care.
Familiarity with CMS regulations, HEDIS measures, and Star Ratings.
REQUIRED KNOWLEDGE / SKILLS
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
Ability to manage multiple priorities and meet deadlines.
PREFERRED QUALIFICATIONS
Experience with ISNP programs or long-term care settings.
Knowledge of quality reporting tools and data analysis software.
Certification in healthcare quality (e.g., CPHQ) is a plus.
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr