Title: Quality Coordinator I
Report To: Quality Manager
FLSA Status: Non-exempt
The Quality Coordinator (QC) position is an administrative role providing support to our clinical offices for the HEDIS and ACO programs, which are government healthcare quality programs. Each program has a set of care measures that we look to complete with our patients. They include preventive care screenings and treatments, such as routine mammograms and cancer screenings. Our department reviews medical records to ensure our patients have completed these important care measures. We also provide assistance to offices that need help collecting and reporting this information. We do a lot of medical record review and data entry.
Additionally, this position makes outbound calls to (and fields incoming calls from) patients to schedule appointments and discuss their personal health matters, such as medication refills and health history. There may also be opportunity to work directly with patients in a clinical setting.
It is critical for the QC to have knowledge of 5 STAR, HEDIS, ACO, CMS guidelines, and NCQA specifications. We can train on the programs, but healthcare experience or education is required. There is a preference for the candidate to be bilingual English/Spanish.
- Critical Thinking / Problem solving
- Ability to use Microsoft Office, with a focus on Excel (or Libre Calc)
- Ability to collect and accurately relay pertinent information
- Ability to navigate computers, internet programs, and EMR systems
- Accurate, efficient data entry
- Ability to read/understand medical terminology
- Ability to read, understand, and analyze medical records
- Ability to read and understand technical specifications on all quality initiatives
Duties and Responsibilities include, but are not limited to:
- Assists with all quality measures initiatives, working with clinical offices in capturing the data to support the variables.
- Works all gap reports for 5 STAR and ACO quality measures projects as they become relevant and assists with all quality initiatives as assigned.
- Inbound and outbound calls to patients to discuss personal health matters, collect history, and schedule appointments
- Assists with patient events as needed.
- Accurately enters all identified and validated measures into the practice's software program(s).
- Directs calls and questions to appropriate individuals.
- Timely and accurately reports issues to management, as necessary.
- Meets daily and overall productivity and compliance expectations.
- Processes and stores incoming supply orders as needed.
- Monitors and replenishes printer paper and toner as needed.
- Other duties as assigned.
Education and Experience:
Diploma or GED.
Previous healthcare experience or education required. This includes, but is not limited to, medical office, medical records, or healthcare quality.
Knowledge of Microsoft Office programs is required. Must be able to demonstrate abilities in data entry, Excel, and Word via testing at interview.
Ability to read and comprehend medical terminology, instructions, technical specifications, manuals, correspondence, and memos.
Ability to write simple correspondence.
Ability to speak to and understand individuals from diverse backgrounds.
To perform this job successfully, an individual must have knowledge of Microsoft Office programs and have an ability to navigate computers, internet programs, and EMR systems.
The noise level of the work environment is usually moderate.
The employee must have close vision ability. While performing the duties of this job, the employee may sit for long periods, use hands and arms, talk and hear, bend, twist or turn head/neck, and occasionally lift up to 50 lbs.
Job Type: Full-time
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Personal protective equipment provided or required
- Temperature screenings
- Social distancing guidelines in place
- Sanitizing, disinfecting, or cleaning procedures in place