Quality Program Specialist

Why Join Us? 

For us, what matters most is excellence. We are caring professionals, people who live, work and dedicate themselves to the communities within New Jersey and Pennsylvania. As such, we strive to provide a sanctuary of excellence, precision, thoroughness and genuine compassion. We also take a whole-person approach to patient care and treatment, tailoring all that we do around their unique needs. And we do all we can for patients, going the extra mile to see that they’re supported, informed and getting the one-on-one care and service they deserve.

Summary

The Quality Program Specialist will be responsible for assisting in the administration of quality programs contracted with Astera and Solara, ensuring they remain fully updated on program guidelines, requirements, implementation and changes.

Job Responsibility

• Assesses and revises clinical workflows to improve quality metrics and reporting across the board.

• Maintains up-to-date knowledge of OncoEMR, Knowtex and other systems used for clinical documentation.
• Monitors for changes to annual measures, coding, documentation requirements, and quality program requirements.
• Works closely with clinical and billing team to ensure appropriate quality reporting levels and coding are maintained for all applicable specialties.
• Create performance dashboards using powerbi, one analytics or other platforms.
• Consistently monitors various quality program reporting and performance using the dashboard to identify metric outliers.
• Work with leadership, managers, and other clinical team members to improve metric outliers.
• Provide clinical documentation improvement education by reviewing samples of reports and clinical documentation.
• Develop, distribute, and educate quality program requirement materials.
• Assist in development and implementation of coding guidelines to meet quality program requirements.

Qualifications

• Bachelor's Degree: Preferred
• Three years’ experience with healthcare EMR’s, clinical documentation review experience, and coding
• Experience with MIPS or similar payer quality programs preferred

Work Environment:

• Office / Hybrid within New Jersey
• Travel to all offices as necessary

We are proud to offer a comprehensive benefit package and paid time off. The health benefits include immediate eligibility for medical, dental, vision, life, disability, HSA, FSA and other ancillary benefits. We also offer a 401(k) plan with company contribution, profit sharing, tuition assistance and employee referral bonus.