Director, Medical Cost Management
Well- Full Time
- Senior (5 to 8 years), Expert & Leadership (9+ years)
Candidates should possess a Bachelor's degree in a relevant field, along with direct experience with HEIDIS or Quality Measure reporting, and the ability to work with multiple large datasets and cross-walking data features across membership. Previous experience with SQL Azure, SAS, Databricks, and Jira is required, as well as analytical skills to identify issues and develop solutions to improve reporting quality, and effective communication skills to present complex data and findings clearly to stakeholders.
The Manager, Quality Reporting will assist in planning, organizing, and overseeing quality reporting, monitor and evaluate performance metrics and assist in identifying areas for improvement, coordinate and support the implementation of new and existing quality programs, manage and track progress of ongoing projects, ensure they align with organizational goals, organize project meetings, prepare agendas, and manage deliverables, facilitate communication between departments, prepare reports, presentations, and correspondence for the Director, manage and prioritize incoming requests and communications, address operational issues and assist in developing solutions to improve processes, serve as a liaison between various departments and the Director of Actuarial Services, facilitate smooth communication and collaboration across teams, assist in ensuring compliance with regulatory requirements and organizational policies, and support quality assurance initiatives to enhance patient care and operational efficiency.
Specialized kidney care management services
Interwell Health manages kidney care by partnering with physicians to improve healthcare for patients with kidney disease. They focus on early detection and prevention, aiming to enhance patient outcomes and quality of life while reducing healthcare costs. Their services include patient education, personalized care plans, and data analytics, all designed to delay the progression of kidney disease. By aligning their financial incentives with patient health outcomes, Interwell Health is dedicated to transforming kidney care through a value-based approach.