Quality Improvement Specialist

The estimate displayed represents the typical salary range of candidates
hired. Factors that may be used to determine your actual salary may include
your specific skills, how many years of experience you have and comparison to
other employees already in this role. The typical candidate is hired below
midpoint of the range.

Introduction

Are you passionate about the patient experience? At HCA Healthcare, we are
committed to caring for patients with purpose and integrity. We care like
family! Jump-start your career as a(an) Quality Improvement Specialist today
with HCA Healthcare.

Benefits

HCA Healthcare, offers a total rewards package that supports the health, life,
career and retirement of our colleagues. The available plans and programs
include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits
_Note: Eligibility for benefits may vary by location._
Come join our team as a(an) Quality Improvement Specialist. We care for our
community! Just last year, HCA Healthcare and our colleagues donated $13.8
million dollars to charitable organizations. Apply Today!

Job Summary and Qualifications

The Quality Improvement Specialist is to help manage the quality
improvement initiatives and Medicare reimbursement programs. In addition to
adhering to set project deadlines, the Quality Improvement Specialist is
expected to collect data for further analysis and submission to complete the
requirements of both projects. The Quality Improvement Specialist also assists
in provider training, initiatives and projects related to their primary
programs.
What you will do:

• Generate and send letters regarding quality improvement programs to providers on a regular basis.
• Generate and send courtesy reminder letters to patients as needed.
• Attend regular meetings with Health Plans and Vendors to keep up with program changes and requirements.
• Adhere to regular project deadlines throughout the year.
• Attend conferences when appropriate and approved to increase knowledge of QI programs.
• Provide assistance to offices as needed. This may include documentation training, office visits, phone meetings and/or assistance with completing program requirements.
• Medicare Reimbursement: HCC (50%) Review and process/document all supplemental data (E.g. Ascender green sheets and Optum PAFs).
• Assist in all processes of chart reviews with a goal of optimizing coding practices and identifying areas of possible provider training. (E.g. Internal audits, Health plan audits and CMS RADV audits) Schedule and participate in provider training as needed. (E.g. HCC software, documentation and coding guidelines)
• Recommend projects to improve data capture and/or provider documentation.
• Quality Improvement: P4P, CMS 5 star, ACO Performance Metrics (50%) Review quality data for accuracy through various reports available through POL, NCQA, and health plan reports.
• Follow up on any issues to ensure data completeness.
• Review, validate and enter all supplemental data (P4P/CMS 5 star).

What you will need:
EDUCATION:

• Bachelor’s Degree required

EXPERIENCE:

• Three years of experience in the managed care industry, and familiarity with QI initiatives and/or HCC is a plus required
• Experience with QI and/or HCC
• Some Medical Terminology
• Some diagnosis (ICD-9) coding experience
• Proficient use of Microsoft Office (Excel, Word, Powerpoint) and internet-based software tools
• Three years of experience in the managed care industry, and familiarity with QI initiatives and/or HCC is required

Physician Services Group is skilled in physician employment, practice and
urgent care operations. We are experts in hospitalist integration, and
graduate medical education. We lead more than 1,300 physician practices and
170+ urgent care centers. We are HCA Healthcare’s graduate medical education
leader. We provide direction for over 260 exceptional resident and fellowship
programs. We focus on carrying out value-added solutions. These solutions help
physicians deliver patient-centered healthcare. We support HCA Healthcare’s
commitment to the care and improvement of human life.
HCA Healthcare has been recognized as one of the World’s Most Ethical
Companies® by the Ethisphere Institute more than ten times. In recent years,
HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of
charitable care, uninsured discounts, and other uncompensated expenses.
> “The great hospitals will always put the patient and the patient’s family
> first, and the really great institutions will provide care with warmth,
> compassion, and dignity for the individual.”- Dr. Thomas Frist, Sr.
> HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal
growth, we encourage you to apply for our Quality Improvement Specialist
opening. We promptly review all applications. Highly qualified candidates will
be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer and value diversity at our company. We do
not discriminate on the basis of race, religion, color, national origin,
gender, sexual orientation, age, marital status, veteran status, or disability
status.
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