What are the responsibilities and job description for the Quality Improvement Coordinator position at Desert Oasis Healthcare?
Provides support for Quality & Compliance Department which requires a variety of office skills (correspondence letters, file maintenance, telephonic surveying, etc.) and familiarity with various computer programs and office equipment.
- Letter Preparation & Distribution - Prepare or assist with preparation and distribution of QI Program activity outcome letters, e.g., Continuity of Care, Annual PCP Ambulatory-Patient Safety audit. For confidential issues, will initiate draft letter to member and Health Plan for Director or VP review and signature and initiate provider query and attach pertinent records, when appropriate. Enter case in tracking system and distribute letter to member, health plan, and provider.
- Grievance Processing – Responsible for continuing processing of grievance cases, following submission to health plan, including transporting confidential cases to-from QIC Chair for review-leveling, EZCAP action-result coding updates and ensuring system matches hard copy file, completion of Grievance form, preparing and mailing out of provider outcome letter, with copy to Credentialing file. Will bring to QI Director’s attention any cases where there may be more appropriate code,type,subtype selection since initial entry.
- HEDIS – Project Coordinator for HEDIS endeavors, i.e., sort various Health Plan pull lists, track all incoming packages from QI nurses (ensuring no duplicates), and send (via secure portal, email, fax) to respective Health Plan by specified deadline. Prepare final billing invoices and submit for Director approval-signature. Send signed invoice to Health Plan for reimbursement and track receipt of funds. Primary contact person for all Health Plan status calls. Send project completion updates to Director and QI staff.
- Policy & Procedures - Responsible for transcribing new policies within department, assisting department heads with formatting-updating their policies, and ensuring Director-Supervisor notification of Intranet posting of P&P, and maintaining QI/MM PTO Calendar, as requested.
- QI-UM Work Plan - Assist with preparation of QI & UM Work Plans, QI & UM minutes, including generation of revisions, as directed, through completion.
- Provider Satisfaction - Ensure Provider Satisfaction Surveys are prepared and distributed timely, in accordance with annual matrix and appropriately tracked, entered and report generated.
- File Maintenance - Maintain accurate document system files related to QI, e.g., HEDIS, Health Plan correspondence, QDI, PQI, SOC, Non-Compliance letters.
- Document Retrieval - Retrieve documents-files, P&P’s and records in a timely manner, as requested by VP Quality & Compliance, VP Clinical Services, QI Director, HPN Corporate.
- Assist with meeting coordination and execution. This includes, but is not limited to: scheduling, coordination, room reservation, set up, preparation of relevant documents and materials, and minute taking.
- Alternate-back-up coverage – Will maintain knowledge of processes to provide coverage when necessary. Will prepare Department-staff meeting minutes, assist with A&G administrative duties, and monitor Gold Fax at least hourly and distribute information appropriately.
- Performs other duties as assigned.
- High school Diploma or equivalent required.
- 2-3 years of previous administrative experience in healthcare environment such as clinic, physician office or hospital setting preferred.
- Excellent computer skills required. Proficient with Microsoft applications (Word, Excel, Power Point) and Outlook.
- Detail oriented and strong organizational skills required.
- Able to multi-task and work independently.
- Able to interact effectively with co-workers, other department staff members, physicians and their staff, and outside contracted providers.
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