Edgar Ascuas
Clinical Quality Improvement Liaison @Horizon Blue Cross Blue Shield of New Jersey
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WORK HISTORY
Clinical Quality Improvement Liaison @Horizon Blue Cross Blue Shield of New Jersey
Newark, NJ, US
Monitor and analyze provider Quality Performance Reports. Identify areas of improvement, provideassistance with root cause analysis, assists with developing solutions, and develop a work plan tomonitor progress.During HEDIS season, assists with the retrieval of charts, chart abstraction, and chart review entries.CQM must adhere to the HEDIS guidelines for chart review abstractions and standards.Provide HEDIS provider guidelines that highlight appropriate HEDIS codes for claims submission.Assists in the development of member and provider outreach, engagement, and education materials toimprove Quality Performance.Serve as key liaison between Medical Directors, Management leadership, and staff. Also serve as amedical resource to members and providers, as well as non-clinical staffCoordinates data collection, reviews compliance reporting and identifies opportunities forimprovements. Identifies and implements cost saving/revenue generating opportunities
EDUCATION
Saint Peter's University
Master of Business Administration (M.B.A.), Finance
Saint Peter's University
Bachelor's degree, Business Management
SKILLS
ABOUT EDGAR ASCUAS
Dedicated Data analyst with 10 years of experience. Highly organized with well-regarded…
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