What are the responsibilities and job description for the Quality Coordinator position at CommonSpirit Health?
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
One Community. One Mission. One California
Responsibilities
***This position is hybrid.
Position Summary:
The Quality Coordinator will assist in the promotion of quality management activities related to monitoring, assessing and improving performance in health care delivery and services to value based care patients. The Quality Coordinator is responsible for executing on strategies and interventions that enhance member participation and drive patient behaviors that improve health outcomes.
Responsibilities may include:
- Execute on local, member facing quality initiatives, designed in alignment with National and Value Hub strategy.
- Perform quality management activitiesrelated to data collection, data review, and report preparation.
- Implement member engagementstrategies to increase participation in Vale Hub programs and initiatives.
- Support member quality initiatives to improve HEDIS and Stars performance.
- Conducts telephonic outreach to members to close quality care gaps for CMS Medicare Advantage Stars, Medicaid, and Marketplace Quality measures.
- Conducts telephonic outreach to members to assist in accessing and scheduling preventative services,such as screenings and annual wellness visits (AWV), drive member engagement, and enlist members in care coordination services.
- Support initiatives to drive participation in annual wellness visits.
- Request, maintain, and organize members’ medical records from contracted providers to complete analysis on areas of opportunity or critical gaps.
- Ability to navigate through patient information in an Electronic Medical Record (EMR) or a paper medical record.
- Develop an understanding of clinical HEDIS measures.
- Ability to handle various situations in a professional manner, demonstrating excellent customer service at all times, and ability to adapt to change.
- Ability to continually re-prioritize to meet the needs of internal and external customers throughout the workday.
- Maintain case files ensuring compliance with all governing regulatory agencies, document status, and resolution outcomes for each case. Maintain database tracking.
- Compose and distribute pertinent correspondence with members, vendors, providers, and other entities to maintain timeliness and accuracy standards. Gather relevant information, medical records, and other documentation to support each case.
- Willingness to work as part of a team, working with others to achieve goals,solve problems, and meet established organizational objectives.
- Must be reliable in attendance and timeliness to work. Executes PHSO Quality Outreach strategy and delivers on standards set by central function.
Qualifications
Minimum Qualifications:
- 2 years experience in an administrative position.
- Experience in Microsoft Office applications; Excel, Word, Access, Outlook, PowerPoint, Project, or other similar programs and/or applications.
- Willingness to work as part of a team, working with others to achieve goals, solve problems, and meet established organizational objectives.
- Ability to create professional documents using proper grammar, punctuation, and appropriate reading level.
- Awareness of clinical HEDIS measures.
- Ability to learn and use other software such as, QNXT, NextGen, and other electronic medical records.
- Ability to navigate through patient information in an Electronic Medical Record (EMR) or a paper medical record.
Preferred Qualifications:
- Experience in health care setting and pay-for- performance or similar programs preferred.
- Associates degree or a clinical Certification, such as medical assistant preferred.
- Ability to handle telephonic engagement with diverse patient populations preferred.
- Statistical analysis and database skills a plus.
