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STAR Specialist in Orange at Prospect Medical Systems

Date Posted: 9/11/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    9/11/2018
  • Job ID:
    10512

Job Description



STAR Specialist

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

Work with Health plans to identify and reconcile records of Star measure patients; Update records as necessary in all systems; Create yearly guides on the 5 Star Measures for both internal use and provider office use, provide CMS star training to internal and external users. Contact Senior members who are due for their Star Measures, follow up with Provider offices for chart notes.



Job Responsibilities/Duties

  • Main contact for Health Plans Star measure initiatives. Reconcile HP Reports with Ascender Data. Develop Star education materials for provider offices, Performance Program Staff, new physician orientation, etc. Identify opportunities for Star code capture — may include reviewing past chart sweep data and Ascender reports.
  • Initiate Star coding intervention with provider offices to improve their coding accuracy. Monitor and champion use of Ascender's STAR and CM modules. Reach out to members as necessary.
  • Develop, maintain, and report on measures associated with CMS Star Ratings using Ascender data.
  • Assist in maintaining quality dashboard reports.
  • Summarize information obtained from webinars, conferences, etc. on Medicare Star Ratings for distribution to the Performance Programs department and provider office. Assist with CMS STAR projects as needed. Project yearly goals a develop ways to improve and capture STARS.
  • Visit provider offices as needed for face to face training on Star Measures. Negotiate with HP for reimbursement for work effort.


Qualifications

Minimum Education: High School Diploma or Equivalent; BS/BA preferred.

Minimum Experience: None.

Req. Certification/Licensure: None.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm