Job Details

Provider Recruiter - CMS QIO Quality Program
Introduction

The Centers for Medicare and Medicaid Services (CMS) will implement new Quality Programs for Medicare providers across the nation. Through these Quality Programs, CMS seeks to promote optimal health and well-being through improved quality of care, equity, and outcomes for Medicare beneficiaries. These services will be available to providers who contract with a qualified Quality Improvement Organizations (QIOs). This Quality Program will be in effect for five (5) years.

EWINGS is seeking individuals to assist our client (a QIO) in the recruitment of providers to participate in their Quality Program. When a provider engages with our client, they will be provided with high-quality, hands-on assistance in meeting their needs, and the healthcare quality and safety goals for their Medicare covered patients. For example, some providers may receive support and guidance to achieve safer hospital inpatient and nursing stays with reduced healthcare acquired infections, adverse drug events, falls, and pressure injuries. This support and guidance may be in the form of emerging technology such as AI tools, machine learning, ambient sensors, hand hygiene monitoring, and techniques to improve staff engagement. There is no cost to the provider.

Provider Recruiters will be responsible for developing relationships with their assigned providers and helping them to understand how our client's Quality Program can address their needs and challenges and then communicate the Quality Program value to the provider. The end goal is for the provider to sign a Provider Services Agreement to participate in our client's Quality Program.

Our aim is to facilitate providers agreeing to long-term participation in the Quality Initiative work. Your initial outreach will set the stage for a successful long-term partnership between our Client and the Provider.

Project Details

This is a temporary assignment expected to last 7-9 months. There is an opportunity to be considered for contract extensions to help implement the newly signed providers.

Responsibilities

• Cultivate positive, functional partnerships with provider practices, nursing homes, or hospitals through strategic, provider-focused communications with a customer-service oriented spirit.
• Maintain timely and effective communications with your assigned provider practices, nursing homes, or hospitals.
• Introduce the provider to the range of services available to improve target provider practices, nursing homes or hospitals' quality.
• Help assigned providers understand the type of support that the Client (QIO) can provide.
• Advocate on behalf of the provider to the Quality Team and liaise with program counterparts to translate provider needs into requirements for the provider's Provider Service Agreement.
• Secure a fully executed Provider Service Agreement (PSA).
• Once a target provider signs a Provider Service Agreement (PSA), develop a plan to facilitate a warm handoff to the Client's Quality Team.
• Effectively utilize systems and databases to maintain accurate and comprehensive files such as provider outreach attempts, correspondence, service agreement records, and other reporting as required.

Skills

• Excellent phone demeanor
• Excellent verbal and written communication skills
• Ability to work in a volume-based environment
• Dedicated to improving quality and safety
• Handles details with initiative and good judgment

Knowledge

• Knowledge of either provider office, nursing home, or hospital organizational policies, procedures, and systems.
• General knowledge of the provider landscape in your geographic area.
• General knowledge of common medical terminology and abbreviations.
• General knowledge of the different medical specialties and types of medical facilities
• Surface level knowledge/awareness of the diseases commonly affecting the Medicare population (high blood pressure, high cholesterol, heart disease, arthritis, diabetes, heart failure, chronic kidney disease, depression, COPD, Alzheimer's disease, atrial fibrillation, cancer, osteoporosis, asthma, stroke).
• An understanding of at least one CMS healthcare quality program (HEDIS, ASCQR, CPC+, ESRD QIP, Home Health Quality Reporting Program, HHVBP, Hospice Quality Reporting, HACRP, IQR, OQR, HRRP, VBP, CMMI Models, IPFQR, IRF, LTCHQR, Medicaid-related programs, Medicare Advantage Quality Improvement Program, Medicare Parts C & D, Medicare Shared Savings Program, Nursing Home Quality Initiative, PACE, PCHQR, Quality Improvement Organizations, QPP, SNFQR, SNF VBP).

Preferred Experience

• Provider Relations or Provider Network Contracting experience, or
• Related work history within a qualified Quality Improvement Organization (QIO), or
• Involvement in one of the CMS quality programs listed above, on the provider or corporate side.
• Recruiting or phone sales experience

Other

A work location in the Central or Eastern Standard time zone is strongly preferred.

Candidates should be comfortable with many different modalities of communication, including letters, emails, phone calls, virtual meetings, and on-site visits. The modality of communication used, and the frequency of those communications should be based on local conditions and tailored to meet provider needs.

While these roles are telecommute based, candidates must be open to conducting on-site visits with providers within reasonable travel distance of their primary work location.

If you have experience working with CMS quality programs, have worked with or recruited healthcare providers, have excellent phone demeanor, and an eye for detail - we want to hear from you!

We understand that you might not have experience with this exact type of work before. If you can demonstrate relevant experience where you have gained the necessary knowledge and skills to be successful here, please apply! Just be sure your resume reflects it as well!