Clinical Quality Coordinator

Hale County Hospital•Greensboro, AL

10d•Onsite

About The Position

The Clinical Quality Coordinator is responsible for supporting and coordinating clinical quality improvement activities across the organization’s outpatient clinics: Hale County Hospital Clinic & Moundville Medical Associates. This position works closely with providers, nurses, medical assistants, registration staff, clinic leadership, administration, and insurance payer representatives to identify and close gaps in care, improve preventive and chronic-care measures, and support accurate clinical documentation. This position requires a Licensed Practical Nurse (LPN) or Certified Medical Assistant (CMA) with strong clinical knowledge, excellent organizational skills, and experience working with electronic health records, patient data, quality measures, and insurance-related clinical initiatives. The ideal candidate must also be highly proficient in Microsoft Excel and comfortable managing large patient lists, reports, spreadsheets, and multiple payer portals.

Requirements

Current Licensed Practical Nurse (LPN) license OR Certified Medical Assistant (CMA) credential.
Strong proficiency in Microsoft Excel is required, including the ability to confidently sort and filter data, manage multiple worksheets, work with large spreadsheets, compare data, create basic formulas, calculate percentages, and organize information for reporting.
Strong understanding of medical terminology and common preventive and chronic-care services.
Ability to interpret reports, investigate discrepancies, and follow an issue through resolution.
Ability to maintain HIPAA compliance and appropriately handle confidential patient and insurance information.
Experience working with electronic health records
Previous experience in a physician office, outpatient clinic, medical practice, healthcare quality, care coordination, population health, or similar healthcare setting.
Ability to manage multiple ongoing projects and patient lists, recognize discrepancies in clinical and payer information, communicate effectively with clinical and administrative staff

Nice To Haves

CPR/BLS certification preferred.
AthenaOne experience is strongly preferred.

Responsibilities

Monitor quality measures and care gaps across Medicare Advantage, Medicaid, commercial insurance, and other applicable patient populations using payer reports, dashboards, and electronic health records.
Identify outstanding preventive and chronic-care needs, including wellness visits, cancer screenings, diabetes care, kidney health, blood pressure control, medication reconciliation, and immunizations.
Track completion and documentation of ordered screenings, testing, referrals, and other services; investigate discrepancies and obtain outside records to verify completed care.
Serve as a resource for payer quality initiatives, participate in payer meetings, prepare relevant reports, and track follow-up items.
Navigate insurance portals to review patient quality information and upload records or supporting documentation for gap closure.
Review provider rosters and patient attribution lists, addressing discrepancies with the appropriate payer.
Use AthenaOne or the designated electronic health record to review patient charts and reconcile clinical information with payer quality reports.
Identify missing, incomplete, or incorrect documentation and guide staff on appropriate structured documentation to accurately capture completed services.
Coordinate quality-focused pre-visit planning, review upcoming schedules, and provide care-gap information to clinical staff.
Work with nurses and medical assistants to incorporate quality opportunities into routine chart preparation.
Educate staff on quality measures, documentation, payer requirements, and workflows; develop resources and provide individual assistance as needed.
Maintain accurate patient rosters, quality reports, and outreach lists in Microsoft Excel; reconcile multiple data sources, remove duplicates, and update completed measures and inactive patients.
Coordinate with registration staff, clinical staff, and providers to support patient outreach and scheduling for wellness visits, preventive care, screenings, testing, referrals, and follow-up appointments.
Track outreach attempts, responses, appointments, outcomes, and care-gap status; identify barriers to care and communicate recurring concerns to leadership.
Use Excel formulas, calculations, tables, and charts to analyze performance and maintain monthly and year-to-date tracking of quality measures, outreach, and improvement efforts.
Monitor performance by clinic, provider, payer, and measure; assist with improvement initiatives and track progress toward quality goals.
Conduct periodic chart reviews and audits to validate documentation, identify missed opportunities, and determine follow-up or staff education needs.
Prepare quality summaries and reports for providers, leadership, Administration, and Quality/QAPI committees; maintain supporting records for quality improvement activities.
Perform other duties and special projects as assigned by clinic leadership or Administration.