Eric Hon Email & Phone Number

Hartford, Connecticut, Us

• Directs day to day execution of QM program including accreditation, HEDIS and CAHPS activities• Provides operational reporting support for clinical health services leadership• Manages quality file auditing program and supports inter-rater reliability (IRR) testing process • Accountable for the development of clinical quality studies and corrective action plans• Provides leadership on various quality and risk management steering committees or workgroups• Establish, align, execute department objectives/goals that help achieve overall enterprise strategy • Engaged with external vendor partner relationships at the enterprise and health plan level

Hartford, Connecticut, Us

• Developed and implemented annual quality improvement plan in accordance with strategic goals of the organization and URAC, NCQA or AAAHC accreditation standards• Managed various quality department functions and processes including quality of care complaint/adverse event and quality of service complaint reviews• Conducted annual evaluations of the QM program and population needs assessment• Coordinated activities to comply with annual HEDIS data collection and reporting including medical record abstraction and audit compliance

Hartford, Connecticut, Us

• Developed BI reporting solutions and provided analytical population health insights in support of Utilization Management, Case Management and Disease Management programs for National Accounts and FEHBP• Developed staff productivity metrics dashboard reporting tool for performance management

Hartford, Connecticut, Us

• Managed a team of twelve claims processors including high-dollar review specialists• Managed claims inventory to comply with turnaround time targets• Researched escalated payment issues from claims adjudication such as billing discrepancies or provider contract changes