Lumeris Quality Improvement Specialist in St. Louis, Missouri

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Position:

Quality Improvement Specialist

Position Summary:

The Quality Improvement Specialist is responsible for data coordination and data entry related to quality initiatives, member and provider outreach to support quality initiatives, and the coordination and compilation of documentation associated with quality initiatives. The Quality Improvement Specialist supports the initiatives of the Quality Improvement program.

Job Description:

Role and Responsibilities:

  • Provides coordination and support of the HEDIS project including data coordination and data entry as well as retrieval of medical records.

  • Responsible for the coordination, data entry and validation of HEDIS Supplemental data.

  • Responsible for the coordination and timely completion of quality initiatives.

  • Conducts telephonic outreach to members to support ongoing quality initiatives related to Gaps in Care and HEDIS and Star Rating measures.

  • Prepares spreadsheets and reports to monitor data related to quality initiatives with an emphasis on Star Ratings initiatives.

  • Provides administrative support for routine correspondence related to quality initiatives, including fax, scanning, email, and hard-copy correspondence.

  • Assists with writing departmental operating procedures.

  • Performs other duties as assigned.

Experience, Qualifications and Education:

  • Associates Degree in a health related field required or Bachelor’s Degree in a health related field preferred.

  • 1+ years of experience in Quality Improvement preferred

  • 2+ years of experience in Managed Care

  • Proficiency with MS Office applications including Word and Excel

  • Problem solving skills

  • Excellent organizational skills for prioritizing tasks to meet set deadlines

  • Excellent verbal and written communication skills

  • RHIA, RHIT and or CPHQ certification preferred but, not required.

Lumeris is an EEO/AA employer M/F/V/D.

Location:

St. Louis, MO

Time Type:

Full time

Status:

1 - FT

Join Our Growing Team!

Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. Lumeris enables clients to profitably achieve greater results through proven playbooks based on collaboration, transparent data and innovative engagement methodologies. Lumeris offers comprehensive services for managing all types of populations, including launching new Medicare Advantage Health Plans, Commercial and Government Health Plan Optimization, and Multi-Payer, Multi-Population Health Services Organizations (PHSOs). Currently, Lumeris is engaged with health systems, provider alliances and payers representing tens of millions of lives moving to value-based care.

Over the past seven years, we have tripled in size to more than 800 employees and built the only solution on the market with our proven outcomes. For the past six years, Essence Healthcare, a long-standing Lumeris client, has received 4.5 Stars or higher from the Centers for Medicare and Medicaid Services (CMS). Essence Healthcare was Lumeris’ pioneer client and has been leveraging Lumeris for more than a decade to operate its Medicare Advantage plans, which serve more than 60,000 Medicare beneficiaries in various counties throughout Missouri and southern Illinois.

In 2018, Lumeris was named Best in KLAS for Value-Based Care Managed Services in the area of client-reported impact on the Triple Aim by KLAS Research. This was the third year in a row Lumeris received the award, and it has only been given for three years. As the industry’s most reliable and effective partner for developing population health management solutions, our success is driving tremendous growth in our company. Join us today in making a real difference in how healthcare is delivered!

Why Join Lumeris?

At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.