Health Plan Project Coordinator Senior

Job Number
202810
University Physicians Health Plans
Shift
Day
Department
University Physicians Health Plans - HP Statewide Quality
Position Type
FT: Full-Time
Street Address
2701 E. Elvira Rd.
City & State
US-AZ-Tucson
Posting Category
Leadership - Non-Clinical
New Grad
No

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Health Plan Project Coordinator Senior (Project Coordinator)

 

This position is part of the Medicare division of the Health Plans’ Quality Management Department.  A working knowledge of HEDIS and other 5 Star Measures is essential.  The Project Coordinator oversees the 5 Star Committee and works directly with the Medical Director and other responsible managers to develop and carry through performance improvement initiates.  It is the responsibility of the Project Coordinator to track performance through an extensive dashboard.  The Project Coordinator will be the liaison between the Health Plan and associated vendors and is accountable for process improvement.  The Project Coordinator conducts in-services for providers and staff.  The Project Coordinator promotes member compliance with screenings, medication adherence, etc.  The Project Coordinator also supports the annual HEDIS audit through medical record retrieval and abstraction utilizing a database platform.    

 

Qualifications

  • Experience with Project Management
  • Knowledge of CMS and AHCCCS
  • Working knowledge of HEDIS and 5 Star Measures
  • Aptitude for learning in a fast paced environment
  • Exceptional communication skills
  • Excellent computer skills including the ability to learn new programs
  • Strong attention to detail with a high accuracy level

Schedule:

Monday-Friday: 8:00AM-5:00PM, flexible start time 

 

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About University Physicians Health Plans
The University of Arizona Health Plans (UAHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care.

 

Truven-2013
Stage7-2013

About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to change the way care is provided. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

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Job Summary

The primary purpose of the position is to provide project coordination support for the daily operations of the Clinical Services Department in order to ensure compliance with AHCCCS and CMS requirements. Under the guidance of the Manager or Supervisor, this position will organize and manage program specific data, generating on-going and focused study reports with statistical analysis drawn from the data. Program specific maintenance of tracking, monitoring, member and provider outreach is required. Will provide administrative support functions for programs within the Clinical Services Department.

 

Essential Functions

  • Coordinates specific complex on-going and one time projects which may require dissemination of information to providers and members regarding compliance requirements or applications to various community programs.

 

  • Assists the manager, supervisor and case management staff in the implementation of daily operations and ensures compliance of program specific AHCCCS and CMS requirements.

 

  • Supports the program by entering data accurately into the medical management system or other program, maintains database in order to generate statistical data and analysis for AHCCCS and CMS reports for the manager or supervisor.

 

  • Gathers data that requires contact with providers, members and internal customers for project specific purposes, maintains and analyzes the data under the guidance of the manager or supervisor.

 

  • Utilizes established screening criteria to monitor and track referrals, routes referrals for case management, when appropriate makes community referrals and educates members and providers on internal programs.

 

  • Coordinates the reporting process for Clinical Services by running reports, troubleshooting data verification issues, formatting and tracking the internal certification signature process.

 

  • Supports AHCCCS OFR and bid presentations by coordinating Clinical Service documentation collection, compilation and formatting as assigned.

 

 

Minimum Qualifications

High school diploma/GED or equivalent working knowledge.Experience typically gained through 5 years of experience in administrative support, project coordination, data analysis or medical assistant experience preferably in a health plan setting.

Requires skill in organizing work and records to ensure compliance with regulatory agencies. Ability to communicate effectively, both verbally and in writing. Requires an organized individual who can prioritize the workload to efficiently produce timely and accurate results under varying situations. Skills to manage significant amounts of electronic data through the use of a computerized office suite. Ability to set priorities relative to work load in a fast paced environment and to complete and assist in the management of projects and provides support on a variety of different projects. Ability to multi-task in a fast paced environment with frequent interruptions. Must possess the ability to work cohesively in a team environment.

Preferred Qualifications

Familiarity with AHCCCS and CMS plans and programs preferred. Bilingual skills (English/Spanish) preferred

Additional related education and/or experience preferred.