Quality Payment Program SME

Remote
Full Time
Mid Level
Job Title: Quality Payment Program SME

Project Description:
It’s an exciting time to be joining a rapidly growing small business! Rainmakers Strategic Solutions, LLC, is looking to expand capabilities in the government health care space to support an expanding portfolio of federal healthcare clients. We seek a clinical quality analyst to support the Public Reporting for Doctors and Clinicians initiative.

We are looking for a strong communicator who can analyze quality program requirements, draft reports, support the statistical team, and ensure accurate public facing documentation related to the initiative.

Key Responsibilities:
  • Serve as the CMS Quality Payment Program (QPP)/ Merit-based Incentive Payment System (MIPS) public reporting SME by providing historical knowledge regarding annual measures, program, and policy changes.
  • Provide subject matter expertise to the analytic team regarding QPP measures, collection types, MVPs, IAs, and Promoting Interoperability (PI) measures by identifying annual changes and appropriately adjusting public reporting recommendations for CMS.
  • Develop and coordinate accurate public facing documentation related to public reporting for doctors and clinicians.

Important Tasks:
  • Review all QPP/MIPS measure changes and communicate changes affecting public reporting to the team and CMS
  • Collaborate with the QPP/MIPS implementation teams for review and clarification of annual measure changes to support public reporting recommendations
  • Support analytical processes and perform QA of analytic and clinical deliverables
  • Support concept testing activities 
  • Develop briefing papers and coordinate enhancements with the analytic teams
  • Support Level 2 help desk inquiries and analytic investigations
  • Contribute to development of outreach materials

Education:
Bachelor's degree in a clinical field (such as Nursing) or a Master’s degree in Healthcare Informatics, Public Health, or a related discipline. 

Relevant Knowledge:
  • Deep knowledge of the CMS Quality Payment Program.
  • Ability to interpret clinical measure specifications and assess substantive changes.
  • Medicare Regulations: In-depth knowledge of CMS regulations and guidelines, specifically related to quality programs. Knowledge of the EPCS Program a plus.
  • Hands-on experience with quality measures, measure specification development, or measure implementation.
  • Ability to review and summarize proposed and final rules published in the Federal Register.

Years of Experience:
Minimum of 3-5 years of experience in directly working with clinical quality measures.

Relevant Past Experience:
The ideal candidate will have experience supporting large government healthcare programs.

Special Skills:
  • Analytical Skills: Ability to analyze compliance data and identify trends and issues. 
  • Problem-Solving Skills: Effective in identifying problems and implementing solutions in a regulatory environment. 
  • Communication Skills: Excellent verbal and written communication skills to effectively interact with prescribers, stakeholders, and team members. 
  • Detail-Oriented: Strong attention to detail to ensure accuracy in compliance calculations and waiver reviews. 
  • Collaboration: Ability to work collaboratively with internal and external teams to achieve program goals. 

Software Proficiency:
  • CMS Platforms: Familiarity with CMS platforms and tools used for compliance tracking and reporting. 
  • Microsoft Tools: Proficient in use of Word, Excel, Outlook, and shared communication platforms such as MS Teams 
Note: This is a remote/telecommute position 

 
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