Coordinator, Quality

MemorialCare•Fountain Valley, CA

1d•Onsite

About The Position

The Quality Coordinator is responsible for supporting quality improvement activities for Memorialcare Select Health plan which surround National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) measures and Centers for Medicare & Medicaid Services (CMS) star programs, in collaboration with the Quality Manager, Department Director and Chief Medical Officer (CMO). The position is responsible for process improvement, compiling and analyzing reports in relation to department and quality metrics and productivity. Additionally, the Quality Coordinator supports audits which include timely and accurate processing of quality related needs required to meet Memorial Care Select Health Plan and Plan to Plan Health provider requirements.

Requirements

Minimum of 2 years’ experience working in healthcare.
Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must.
Associates degree (A.A. or A.S) from two-year college or technical school- required.

Nice To Haves

Experience in Health plan or Managed Care setting preferred.
Experience working with various healthcare industry regulatory agencies and requirements including but not limited to CMS, NCQA, DMHC, HICE, DHCS, preferred.
COZEVA experience strongly preferred.
Experience in HEDIS, STARS, medical record audit or review preferred.
Bachelor’s degree (B.A. or B.S)- preferred
LVN preferred
Certified Provider Healthcare Quality (CPHQ) -preferred

Responsibilities

Ability to interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customer or employees of the organization.
Ability to apply commonsense understanding to carry out detailed but uninvolved written or oral instructions.
Ability to deal with problems involving a few concrete variables in standardized situations.
Proficient on Microsoft Word, Excel, Outlook and PowerPoint.
Strong oral and written communication and research/problem solving skills.
Attention to detail and accuracy.
Ability to meet deadlines.
Excellent interpersonal skills with a focus on internal/external customer satisfaction and teamwork.
Proven dedication to quality, teamwork, customer service and professionalism.
Meet or exceed productivity and quality standards as assigned by management.
Take responsibility for various projects as assigned by management and perform any additional/miscellaneous duties (not inclusive of job description) as requested by the management team within the scope of knowledge/ability.
Work as a team player and communicate in a positive manner with co-workers, managers, providers, and other contacts.
Maintain a strict degree of confidentiality in all areas relating to provider credentials, peer review and provider status.
Maintain a safe and orderly work area.
Occasional local travel.
Ability to be at work and be on time.
Ability to follow company policies, procedures, and directives.
Ability to interact in a positive and constructive manner.
Ability to prioritize and multitask