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Job Responsibilities:

• Schedules appointments and retrieving medical records from participating physician offices quarterly either by remote access or field (in physician office) collection.  Reports to Chart Collection Manager

Job Duties:

• Contacts physician offices weekly to schedule available appointments to retrieve medical records.

• Must document all activity with doctor’s office or IntegraNet Departments concerning chart collection.

• Confirm collection method (EMR or paper) when scheduling for field collection.  Bring appropriate collection materials such as laptop and scanner.

• Confirms appointments the day before a scheduled appointment.  Resolve any issues so prospective appointments can be met or rescheduled effectively.

• Updates new appointments daily on the chart collection calendar for physicians and staff.

• Serves as point of contact for physicians and staff concerning chart retrieval for field collection.

• Travels 15% to 20% of time for collection each quarter, this includes Dallas and surrounding areas. 

• Coordinates with other departments – Provider Relations, Coding and HEDIS Review as necessary to ensure proper and quality/usable data in the medical records is obtained.

• Must enter mileage each day for field collection.

• Maintains patient confidentiality by keeping patient records information confidential.

• Other job duties as assigned.

• Cross trains with others to ensure department activities can continue without interruption.

Skills and Qualifications:

• Reliable transportation and clear driving records required

• Must pass background check.

• Experienced in Microsoft Office required

• Heavy scheduling experience required

• Strong time management, productivity, organizational skills and attention to detail

• Professional and flexible, Productive, Deadline-Oriented, Reporting Skills required. 

• Excellent communication skills

• Ability to work effectively as an individual and/or team, self-starter

• Bilingual - Spanish

• Experience reviewing medical records and imaging studies in multiple medical record platforms

• Critical thinking and problem-solving skills

• The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms; The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• This is a full-time position, and general hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.

• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, and filing cabinets. 

Company Benefits:

• In a full-time permanent position, you will be able to participate in our company benefit program which includes:

• Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.

• Employer funded HSA program.

• Paid Time Off ranging from 5-28 days depending on length of service.

• Profit Sharing Bonus Program

• 100% Employer Paid Pension Plan after 5 years

Job Description

Reports to:         Designated Market Lead

Status:                  Full-Time/Exempt

Location:             Dallas, TX

Position Summary:

This position serves as an integral member of the Quality and Provider Relations Team and reports to the designated Market Lead of Employer (IPA).  This role is a key contributor to the training of providers and their staff on HEDIS and GPRO measures and is accountable for all providers achieving a minimum of 4-STAR for HEDIS and 95% quality for GPRO as well as other duties as assigned by the Market Lead. This is a field position requiring travel to doctors’ offices regularly.

Responsibilities:

• Advises and educates providers and their staff in the appropriate documentation of HEDIS and GPRO measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements.
• Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement.
• Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
• Delivers provider specific metrics and coaches Providers on gap closing opportunities.
• Identifies specific practice needs where IntegraNet Health can provide support.
• Leads and/or supports collaborative business partnerships, promote client understanding and insight to advise and make recommendations.
• Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
• Provides resources and educational opportunities to provider and staff.
• Captures concerns and issues in action plans as agreed upon by provider and in formats approved by IPA.
• Documents action plans and details of visits and outcomes and reports critical incidents and information regarding quality of care issues.
• Communicates with external data sources as authorized to gather data necessary to measure identified outcomes.
• Provides IPA approved communication such as newsletter articles, member education, outreach interventions and provider education.
• Supports Provider office-based quality improvement and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history.
• Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
• Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
• Participates in and represents IPA at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned.
•  Works with office-based staff to ensure accuracy in medical records for data collection, data entry and reporting. Enters documentation of findings in identified databases.
• Performs other duties as assigned.

Qualifications:

• Licensed Vocational Nurse (LVN) or Licensed Registered Nurse (RN)
• 5+ years working with HEDIS and GPRO with an IPA or health plan in a senior role.
• Knowledge of computer systems and applications.  Skill in planning, organizing, prioritizing, delegating and supervising. 
• Skill in exercising initiative, judgment, problem-solving, decision-making. 
• Skill in identifying and resolving problems. 
• Ability to anticipate and react calmly in emergency situations. 
• Skill in developing and maintaining effective relationships with medical and administrative staff, patients and the public. 
• Skill in developing comprehensive reports. 
• Ability to analyze and interpret complex data. 
• Skill in developing and maintaining office-based quality improvement.   
• Excellent and effective written and verbal communication skills. 

Company Benefits:

In a full-time permanent position, you will be able to participate in our company benefit program which includes:

• Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
• Employer funded HSA program.
• Paid Time Off ranging from 5-28 days depending on length of service.
• Profit Sharing Bonus Program
• 100% Employer Paid Pension Plan after 5 years
• Employer Sponsored Wellness Program with access to company gym and locker rooms in Houston offices, if applicable.

Reports to:         Designated Market Lead

Status:                  Full-Time/Exempt

Location:             Houston, TX

Position Summary:

This position serves as an integral member of the Quality and Provider Relations Team and reports to the designated Market Lead of Employer (IPA).  This role is a key contributor to the training of providers and their staff on HEDIS and GPRO measures and is accountable for all providers achieving a minimum of 4-STAR for HEDIS and 95% quality for GPRO as well as other duties as assigned by the Market Lead. This is a field position requiring travel to doctors’ offices regularly.

Responsibilities:

• Advises and educates providers and their staff in the appropriate documentation of HEDIS and GPRO measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements.
• Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement.
• Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
• Delivers provider specific metrics and coaches Providers on gap closing opportunities.
• Identifies specific practice needs where IntegraNet Health can provide support.
• Leads and/or supports collaborative business partnerships, promote client understanding and insight to advise and make recommendations.
• Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
• Provides resources and educational opportunities to provider and staff.
• Captures concerns and issues in action plans as agreed upon by provider and in formats approved by IPA.
• Documents action plans and details of visits and outcomes and reports critical incidents and information regarding quality of care issues.
• Communicates with external data sources as authorized to gather data necessary to measure identified outcomes.
• Provides IPA approved communication such as newsletter articles, member education, outreach interventions and provider education.
• Supports Provider office-based quality improvement and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history.
• Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
• Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
• Participates in and represents IPA at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned.
•  Works with office-based staff to ensure accuracy in medical records for data collection, data entry and reporting. Enters documentation of findings in identified databases.
• Performs other duties as assigned.

Qualifications:

• Licensed Vocational Nurse (LVN) or Licensed Registered Nurse (RN)
• 5+ years working with HEDIS and GPRO with an IPA or health plan in a senior role.
• Knowledge of computer systems and applications.  Skill in planning, organizing, prioritizing, delegating and supervising. 
• Skill in exercising initiative, judgment, problem-solving, decision-making. 
• Skill in identifying and resolving problems. 
• Ability to anticipate and react calmly in emergency situations. 
• Skill in developing and maintaining effective relationships with medical and administrative staff, patients and the public. 
• Skill in developing comprehensive reports. 
• Ability to analyze and interpret complex data. 
• Skill in developing and maintaining office-based quality improvement.   
• Excellent and effective written and verbal communication skills. 

Company Benefits:

In a full-time permanent position, you will be able to participate in our company benefit program which includes:

• Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
• Employer funded HSA program.
• Paid Time Off ranging from 5-28 days depending on length of service.
• Profit Sharing Bonus Program
• 100% Employer Paid Pension Plan after 5 years
• Employer Sponsored Wellness Program with access to company gym and locker rooms in Houston offices, if applicable.

We are looking for highly analytical candidates who are as skilled in healthcare administration as they are in business management. Healthcare Data Analysts are quantitative specialists who understand the business needs of an IPA and how to use data to achieve those needs. Their duties include organizing and managing large and varied data sets, analyzing health care data to optimize business operations and communicating their findings using data visualization and detailed reports.

The best healthcare data analysts are diligent problem solvers who use data in creative ways to reach business goals.

Reports to:         Mark Gilliam

Salary:                  $40,000-$50,000

Status:                  Full-Time / Exempt

Location:             Houston, TX

Position Summary:

Responsibilities:

• Compiling and organizing healthcare data.
• Analyzing data to assist in delivering optimal healthcare management and decision making.
• Using healthcare data to achieve administrative needs and goals.
• Understanding data storage and data sharing methods.
• Investigating data to find patterns and trends.
• Understanding healthcare business operations.
• Utilizing different data sources for analyses.
• Converting data into usable information that is easy to understand.
• Developing reports and presentations.
• Communicating analytic insights to management.

Qualifications:

• Bachelor’s degree in Mathematics, Statistics, Healthcare Administration or related field.
• Master’s degree advantageous.
• Proficiency with database programming languages such as SQL.
• Experience with data visualization tools.
• Knowledge of data management applications.
• Proficiency managing electronic medical records.
• Analytical mindset with good problem-solving skills.
• Excellent written and verbal communication skills.
• Good interpersonal skills.

Company Benefits:

In a full-time permanent position, you will be able to participate in our company benefit program which includes:

• Group benefits include medical, dental, vision, company paid $25k life with the option to add more voluntary life insurance coverage for employee and their family, STD, company paid LTD, 401k, and a variety of supplemental coverages such as hospital, cancer, legal, etc. available to the employee and their family.
• Employer funded HSA program.
• Paid Time Off ranging from 5-28 days depending on length of service.
• Profit Sharing Bonus Program
• 100% Employer Paid Pension Plan after 5 years
• Employer Sponsored Wellness Program with access to company gym and locker rooms in Houston offices.