Clinical Quality Coordinator

Neighborhood Healthcare•Escondido, CA

13d•$27 - $38•Hybrid

About The Position

Under the direction of the Quality Leadership Team, the Clinical Quality Coordinator supports clinical and administrative tasks assigned to improve quality performance and maximize incentive opportunities for Medicare members. This is a full-time, hybrid position. Schedule: Monday-Friday, 8am-5pm.

Requirements

High School diploma or GED required
Valid Medical Assistant Certificate from an accredited program required
Two years of medical assistant experience required
Current Basic Life Support (BLS) certification is required upon hire and must be maintained as a condition of employment. These courses must follow AHA guidelines but may be completed through approved online providers such as ProMed or other equivalent programs that meet recognized BLS standards
Strong communication and leadership abilities
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Ability to successfully manage multiple tasks simultaneously
Excellent planning and organizational ability
Ability to work as part of a team as well as independently
Ability to work with highly confidential information in a professional and ethical manner
Ability to work under pressure and be flexible with changing site needs. Can work with people of all social and ethnic backgrounds and maintain confidentiality. Able to train and manage staff in a collaborative manner

Responsibilities

Perform outreach to schedule Medicare members for preventative visits and screenings
Perform eligibility verification to ensure compliance with CMS billing requirements for Medicare preventative visits
Perform pre-visit chart preparation and health risk assessments
Perform post-visit documentation audits to facilitate accurate payor requirement submissions
Provide feedback to care teams and facilitate corrections to ensure documentation supports billing codes
Coordinate training for medical assistants and outreach staff to support preventative visits and services for Medicare members
Function as a resource person for Site Leadership regarding Medicare preventative service guidelines
Provide MA coverage for Medicare preventative visits
Assist in development and implementation of workflows related to quality programs and quality improvement projects.
Research and compile information as needed for planning and organization of quality improvement projects. Prepare agendas, take minutes, and follow up on action items for meetings
Contribute to the success of the organization by participating in quality improvement activities
Research and compile business-related information for quality incentives and special projects
Collect and compile health plan scorecards and internal analytics reports
Run reports and obtain data from the EMR system and analytics
Work closely with the Analytics Department to ensure accuracy of reports
Assists with the implementation and creation of workflows pertaining to the scheduling team, clinical team, and other departments that support in the completion of these visits
Help gather the requirements for documentation, coding, and submission of completed AWVs
Leads and monitors productivity and quality metrics for the department/specific teams and works with department and sites on improved strategies
Serves as a liaison between the health plans, Medicare, and Neighborhood Healthcare to keep track of updates to AWV requirements and to communicate them within organization
Tracks outreach efforts and number of completed, submitted, and credited AWV visits