Clinical Quality Project Coordinator

HealthFirst•New York, NY

3d•$58,900 - $80,070•Hybrid

About The Position

The Clinical Quality Project Coordinator coordinates medical record retrieval activities, including in-person retrievals at provider offices and healthcare facilities. The role submits and tracks requests, follows up on outstanding requests, checks received records for completeness and accuracy, and resolves or escalates retrieval barriers. It maintains accurate activity documentation and collaborates with internal teams, provider contacts, and vendors to support timely completion of medical record requests, supplemental data submissions, and project goals. The position has a hybrid work location, working remotely, in the office, and in the field as needed. The office is located at 100 Church Street, New York. Travel around the five boroughs of New York City and Long Island may be required.

Requirements

High school diploma or GED from an accredited institution.
Ability to travel around the New York City metro area, including the five boroughs, and Long Island as necessary.

Nice To Haves

Associate’s degree or higher from an accredited institution.
Prior experience in Managed Care or Health Insurance, or in a health-related field or environment.
Knowledge of HEDIS/QARR and/or Medicare Stars.
Strong working knowledge of Microsoft Office Suite and Outlook.

Responsibilities

Coordinate medical record retrieval activities from provider offices, hospitals, clinics, and other healthcare facilities, including in-person or on-site retrievals as required.
Submit, track, and monitor medical record requests through approved retrieval methods and maintain accurate documentation of request status and activity.
Follow up promptly on outstanding requests and work with provider contacts to resolve retrieval barriers; escalate unresolved issues as appropriate.
Check received medical records for completeness, accuracy, legibility, and responsiveness to the request, and follow up on incomplete or missing records.
Use internal systems, electronic medical records, provider portals, Microsoft Excel, and other approved tools to track, reconcile, and report retrieval activity.
Provide management and project stakeholders with updates on retrieval progress, outstanding requests, barriers, and completion rates.
Maintain confidentiality and handle medical records and protected health information in accordance with Healthfirst policies and applicable privacy and security requirements.
Meet established productivity, quality, accuracy, and turnaround-time expectations.
Support designated team supplemental data training and submission reconciliation activities for providers and vendors as required.
Participate in required meetings, training, and project activities, and perform additional duties as necessary and directed.