Joseph Powers Email & Phone Number

Hollywood, FL, US

United States

United States

Maintain compliance with all regulatory laws and standards through reporting, training of staff, and implementing various compliance and quality improvement initiatives⋅ Design and implement programs, policies, and practices to ensure State and Federal program contract compliance, as well as compliance with federal and state legal and regulatory.

Florida

Organized and supported Medicare team with the migration of Inovalon (QSI) to Verscend (Cotiviti) with downstream enhancements to the “Gap in Care Report” to provide additional value to Medicare states throughout Anthem.⋅ Managing newly introduce tool for supplemental data to track and streamline communication across all lines of business for inquiries and.

Miami, Florida

 Implement a provider incentive payment system (MPIP) for Molina Florida with state mandated reports being met on time.  Developed an outreach tool in order to reduce cost and improve health through preventive care while cleaning data through multiple touch points. Analyze preventive visits and ER utilization to identify effectiveness for care.

Florida

 Manage the data, process, and training necessary to generate and understand the metrics involved with HEDIS set by NCQA Develops and identify new supplemental data sources for use in HEDIS reporting Oversee the progress and productivity of services rendered for Medicaid, Medicare, and Marketplace Evaluate team performance and project status to develop.

Miami, Florida

 Responsible for the investigative analysis of 7 HEDIS measures including W15, W34, AWC, CIS, IMA, Lead Screening and CAP  Participate in the Medical Record Review processes to emphasize on critical HEDIS abstraction guidelines Understanding population trends in Medicaid, Medicare and Marketplace to support behavioral interventions  Develop member and.

Dearborn, Michigan

 -Analyze, develop, implement and monitor clinical Quality Improvement initatives to achieve healthy outcomes; supporting Molina, HAP, Total Health Care, BCN, BCBSM and Priority Health. -Provide education and consultation to providers’ and provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures.  -Perform.

- Managed and oversaw an $800K new construction build out of our current retail facility, which involved four different contractors simultaneously. Project was finished on time and within budget.- Select and coordinate all new store inventories to meet fluctuating retail demand, which increased sales approximately 30%.- Maintain all supplier relationships.