• Supports and assists with the creation and maintenance of the PACE Audit Universe Data Sets, which are required by CMS regulations.
• Assists participants in filing appeals of denied service requests, including verifying proper communication of appeal rights to participants/caregivers. Facilitates both internal and external third-party appeals of denied service requests.
• Oversees data management for QI activities including coordination of collection, entry, analysis, and assessment of data. Responsible for ensuring that the statistical data collected and reported is accurate, timely and complete. Oversees submission of data into appropriate data submission program (i.e., HPMS).
• Facilitates Corrective Action Plans (CAPs) as directed by the Medical Director and/or Leadership Team when opportunities for improvement are identified. Process includes identification of global problems, development of improvement plans, and implementation of plans to then evaluate their effectiveness. Facilitates CAPs from contracted providers in collaboration with the Director of Finance and Administration.
• Assists in interface between consumers and program management for quality related complaints. Ensures compliance with Federal, State, and Local laws and regulations.

Benefits:

• Health Insurance
• Dental Benefits
• up to $5000.00 of Tuition Reimbursement
• 403B Retirement, Company contribution of 4% & Company matching up to 4%
• Paid Time Off
• Holiday Pay
• Long Term Disability
• Life Insurance
• Optional Benefits
• Employee Assistance Program
• Flexible Spending Accounts

Kintegra Health Core Requirements

1. Patient First – An approach to care that holds primary, the well-being and desires of the patient

2. Build not Blame – Focusing first on finding fault with the process rather than the person

3. Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds and the use of organizational resources judiciously for both internal and external customers

4. Cooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description

5. Culturally Sensitive – Always working toward increasing one’s ability to understand, communicate with, effectively interact and care for people across cultures, while having an acute awareness of one’s own culture.

Kintegra Health has implemented Covid-19 protocols for our current employees and new hires. We are committed to improving our society.

We are an equal opportunity employer and value diversity.