Quality Management Coordinator

Under the direction of the Manager of Quality, this position is responsible to assist with scanning records for health plan and internal audits, as well as assisting with day to day HEDIS and QM administrative duties. The QM Coordinator will interact with other departments, clinic personnel, and outside providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers.

• Communicate effectively with Staff, IPA, and Specialty providers regarding medical record requests and scheduling of scanning.
• Receive and load incoming Senior Wellness Visit notes into the tracker for the auditors in a timely manner.
• Receive and upload supplemental data from HCC auditors & clinician reviewers into NextGen and/or onto the J Drive.
• Assist with HEDIS administrative duties, such as pulling/providing records to health plans for HEDIS data collection, saving/naming/uploading records into q. HMO to close care gaps, and reviewing HCC summaries and boarding passes for quality measures that were closed during a visit.
• Pull weekly A1c report from q. HMO. Request records and upload results once received.
• Review weekly COA report. Pull any completed COAs from NextGen, save, and upload into q. HMO.
• Work closely with the Pharmacy team and assist with getting hospital records, as needed, in order to complete Medication Reconciliations following a hospital discharge.
• Process incoming HCC summaries and boarding passes. Distribute to auditors accordingly and pull and upload any completed quality measures.
• Be familiar with all manuals (HEDIS, AMP, CMS) and have a firm understanding of all quality measures and their criteria.
• Maintain patient confidentiality and follow HIPAA guidelines at all times.
• Attend all staff meetings and complete in services and monthly trainings as required.
• Cultural and Linguistics training required annually.

8.6 Clean DMV record, current CA driver's license, and current car insurance

The pay range for this position at commencement of employment is expected to be between $24.27 and $28.55 however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.