About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.
This position is accountable for supporting the delivery system to improve member’s health outcomes, oversight of assigned delegated activities and participation in the company’s STARS and GIC quality improvement initiatives by: 1) Assisting providers to deliver improved patient care. 2) Educating the provider community on impact of CAHPS, HOS and HEDIS on member outcomes and STARs performance. 3) Assessing provider office practices for opportunities that positively impact member experience and impact HEDIS, CAHPS and HOS ratings. This position will be required to communicate and collaborate with value based and non-valued based partners as well as other stakeholders to effectively manage the delivery of strategies, plans and improvements to HEDIS, Medicare Stars, GIC Quality Improvement Initiatives, Qualified Health Plans/Quality Rating Systems and other clinical quality measurements. Knowledge and utilization of health analytic tools is required to identify opportunities to improve satisfaction and quality.
Primary Job Responsibilities
Perform other duties as assigned.
Must be able to work in a multi-functional team setting