Quality Coordinator

Job Title: Quality Coordinator

Duration: 20 weeks

Location: San Ysidro CA 92173 (onsite)

Monday to Friday 8 am 5 pm

• Will be making outbound calls constantly on the phone doing outreach handling excel spreadsheets scheduling appointments repetitive in nature
• Must have EPIC experience
• Experience with Medicaid/Medicare claims adjustment
• Must be Bilingual (English/Spanish)
• Experience with Health/ Medical standards such as HEDIS NCQA etc.
• Health related call center experience is a plus
• Must have minimum 2 years experience

Position Summary:

Under the supervision of the Quality Manager assist in all activities related to the San Ysidro Health quality management program which includes: assisting with organizational adherence to federal state and other regulatory requirements; monitoring and maintaining compliance with NCQA PCMH recognition standards; TJC ambulatory accreditations standards; and facilitating a state of continuous clinic audit readiness.

Essential Functions of the Job:

• Track key performance indicators related to regulatory clinic compliance audits surveys and studies by health plans federal and state agencies.
• Track and support as directed by the Quality Manager continuous audit readiness activities.
• Support care team training activities to improve clinical quality performance and adherence to regulatory health plan and other program participation requirements.
• Coordinate peer review activities by maintaining an annual calendar preparing records for review and collecting data for review.
• Provider administrative support for quality improvement studies addressing areas of opportunities. Maintain and update departmental project work plans as needed.
• Participate in departmental PCMH and CQI meeting for alignment and tracking of active projects.
• Facilitate project milestones by coordinating followup activities internally and cross departmentally.
• Provides support in capturing and updating policies procedures practice guidelines and clinic protocols that impact clinical quality.
• Keep abreast of PCMH and TJC program requirements and updates.
• Assist gathering data for quality related reports for regulatory submission and as requested by the board Executive and Department leadership.
• Adheres to SY Health and departments attendance and punctuality policies and practices.

ADDITIONAL DUTIES AND RESPONSIBILITIES:

• Perform other duties as assigned.
• Enhance professional growth and development through participation in educational programs current literature inservice meetings and workshops.
• Attend meetings as required and participate in committees as directed.

JOB REQUIREMENTS:

• Education Required (Minimum level of education): High School Diploma
• Training/Certification: Valid California drivers license with appropriate insurance.
• Experience Required (Minimum level of experience): Two years experience in healthcare or a closely related field; familiarity with the PCMH model of care the continuum of care transitions of care and quality improvement processes.
• Experience in chart review and medical record documentation.
• Verbal and Written Skills Required to Perform the Job: Excellent oral and written communication skills required.

Technical Knowledge and Skills Required to Perform the Job:

• Proficient in Microsoft Excel Power Point and Word and attention to detail.
• Equipment Used: Networked personal desktop document center and telephone.
• Working Conditions and Physical Requirements: Prolonged periods of sitting and standing driving within the country to travel between clinic locations and to occasional community partner meetings.
• May be required to work evenings and/or weekend.