Quality/HEDIS Manager

Welcome to Arkos Health! We are a value-based healthcare company providing solutions for payors and providers by combining unique technology with in-home, virtual, and in-clinical care for patients. Arkos serves health plans and provider organizations by managing their highest-risk and highest-cost populations.  We are currently in Arizona, Georgia, Montana, Nevada, North Dakota, Illinois and Vermont! Our goal is to be the most valued partner to health plans, service providers, and the community we collectively serve. 

We are looking for a Quality Manager to join our team! 

Why Arkos? 

• Great Benefits! 
  
  
  
  • Employer-paid Medical, Dental and vision premiums at no cost to you 
  
  
  • Employer-paid Short-Term Disability premiums at no cost to you 
  
  
  • Employer-paid Life Insurance premiums at no cost to you 
  
  
  • Employer matching 401(k) 
  
  
  • 15 days annual combined sick/vacation and 9 days of holiday during your first year 
  
  
  • Your Birthday off! 
  
  
  
  

• We have great people and a growing culture! From coffee bars to Ice Cream Day, we recognize our team!  


• We are ranked as the 113th fastest-growing private company in the United States and 11th within the healthcare services sector on the 2024 Inc. 5000 list! Join us today! 

How You'll Make a Difference: 

The Quality Manager will be responsible for providing oversight and direction to the STARS/HEDIS department. The Quality Manager is tasked with holding staff accountable to Departmental goals. They will schedule and follow up on clinical care needs for patients as it relates to Quality Data, including but not limited to Healthcare Effectiveness Data and Information Set (HEDIS). The Quality Manager will manage staff in the STARS/HEDIS Department and assist staff in quality initiatives, including STAR initiatives. They will collect, report, and respond to metrics and contribute to the organization's drive to improve the overall experience of patient care, including the quality of health, and work to reduce the cost of care across the population served. 

Essential Duties and Responsibilities: 

• Review and provide performance feedback to the STARS/HEDIS department


• Establish annual and monthly departmental and individual staff goals 


• Ensure the training and on-boarding of new staff 


• Provide day-to-day management of staff 


• Perform quarterly performance reviews all Arkos Health Quality department staff 


• Provide education regarding STARS/HEDIS initiatives to staff and outside individuals


• Attend Arkos Health educational and demonstration activities, as needed and directed by Executive Medical Director


• Perform the duties of STARS/HEDIS team members, as needed


• Review data collected and to develop strategies to improve performance 


• Implement strategies to improve department performance 


• Create, maintain, and improve written department process flows and procedures to improve the functioning of the department 


• Ensure gaps in care are captured


• Coordinate and order preventative and diagnostic tests around gaps in care on behalf of the primary care physician utilizing standing orders/protocols required by the health plan


• Conduct data entry and maintain appropriate documentation and tracking for quality initiatives 


• Educating patients on procedures that are being performed and the reason for performing them


• Participate in member chart review by conducting data extraction/collection using Insurance/Medicare guidelines


• Collaborate with the PCP in the management and care coordination for members with open gaps of care


• Demonstrate the ability to work collaboratively, efficiently, and effectively as a high performing quality team member, including collaborating with stakeholders when applicable 


• Coordinate and participate in internal and external meetings.  


• Contribute as an active participant in quality initiatives. 


• Follow Arkos Health procedures, practices, policies, and guidelines to ensure the safety, security, and wellbeing of patients 

 Qualifications and Skills: 

• Bachelors Degree in related field (preferred)


• 1+ years’ experience as a manager


• 2+ years' experience in a healthcare environment


• Recent and related experience working with HEDIS STARS Program


• Experience in Electronic Health Records


• Experience with verifying eligibility and navigating through Insurance Portals


• Experience with CPT II codes


• Basic knowledge HCC’s and Medical Diagnosis


• Ability to perform multiply procedures with training (i.e.) ABI, DRE, Urine Dips 


• Familiarity of Medicare guidelines to perform patient screening’s K. Knowledge of medical terminology


• Current unrestricted state driver’s license with personal reliable transportation


• Proof of liability insurance coverage
  

What's Next? 

Apply for the Job! Our recruitment team will review your application and reach out to schedule a quick call! 

Please feel free to forward this opportunity to someone you believe might be a good fit! If hired, you could be eligible for a referral bonus! 
 
Must complete our Culture Index Survey. Take the assessment at https://go.cultureindex.com/s/bg3VS0H2kF. This is not a pass/fail test and does not measure intelligence.  

Arkos Health EEO Statement:  

Arkos Health Inc is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.  

Arkos Health is a drug-free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.  

Arkos Health participates in E-Verify to confirm eligibility to work in the United States. To view the details on this program, visit our career page at
Careers - Arkos Health