PACE Quality Coordinator

United Health Centers of the San Joaquin Valley•Fresno-Corporate, CA

14h•Onsite

About The Position

The PACE Quality and Coordinator is responsible for supporting the implementation, monitoring, and evaluation of the Program of All-Inclusive Care for the Elderly (PACE) Quality Improvement and Compliance Program. This position works collaboratively with the interdisciplinary team (IDT), leadership, and operational departments to ensure compliance with Centers for Medicare & Medicaid Services (CMS), California Department of Health Care Services (DHCS), and PACE regulatory requirements. The Coordinator supports participant compliance initiatives, quality improvement activities, incident management, grievance and appeal oversight, quality reporting, audit readiness, performance improvement projects, and regulatory compliance efforts. This position serves as a key resource in promoting a culture of continuous quality improvement and participant-centered care.

Requirements

Bachelor's degree in health sciences, business, healthcare administration, health information management, or management engineering, preferred.
Three years of relevant experience, including conducting and managing a continuous quality improvement project in a healthcare environment, safety, and relevant managed care and clinical experience.
Able to quickly build and maintain rapport with patients and providers of differing backgrounds; team player.
Customer-service oriented.
Possesses basic tools of continuous improvement, work process redesign, or re-engineering.
Excellent computer skills (MS Office products) and ability to learn new software quickly.
Descriptive statistics and a comprehensive understanding of the appropriate applications of interpretive statistics.
Able to handle multiple tasks simultaneously.
Familiar with learning and development concepts.
Analytical reasoning; interprets and evaluates complex information, while identifying patterns and essential issues.
Strong computer skills and familiar with modern office practices and procedures, including email.
Familiar with adult learning and general training techniques.
Positive professional insight.
Flexibility and dependability.
Demonstrated good problem-solving skills; sound judgment.
Effective leadership skills
Attention to detail and excellent follow-through on work tasks.
Competency in gathering information and understanding context from several sources, with the ability to analyze this information, draw conclusions, and make recommendations, is required.
A high degree of comfort, experience, and credibility in interactions with healthcare leaders, including "C" level executives and Medical Directors, is essential to success.
Advanced Word/Excel PowerPoint experience
Experience conducting Root Cause Analyses (RCA), Failure Mode and Effects Analysis (FMEA), quality audits, and performance improvement initiatives.
Experience developing dashboards, quality reports, and executive-level presentations.
Ability to interpret regulatory requirements and translate them into operational workflows and quality improvement initiatives.

Responsibilities

Coordinate implementation of the PACE Quality Improvement Program.
Monitor compliance with PACE quality standards, policies, and procedures.
Assist in the development, implementation, and monitoring of Quality Improvement initiatives.
Collect, analyze, trend, and report quality performance data.
Support annual Quality Improvement Program evaluations and work plan development.
Assist with quality improvement projects utilizing Plan-Do-Study-Act (PDSA) methodology.
Coordinate the PACE Safety Committee with the PACE manager, including agenda development, meeting facilitation, documentation of minutes, follow-up on action items, and reporting to the Quality Management Committee.
Assist the Manager and coordinate the implementation and monitoring of the PACE Transportation Safety and Risk Management Program.
Develop and maintain the monthly PACE Safety Dashboard, including collection, analysis, trending, and reporting of participant safety indicators.
Monitor, analyze, and report participant safety metrics, including: Falls with injury, Medication errors, Pressure injuries, Infections, Emergency Department visits, Hospitalizations, Transportation incidents, Vehicle accidents, Home safety concerns, Abuse, neglect, and exploitation allegations, Elopements, Emergency preparedness activities.
Coordinate Root Cause Analyses (RCA) for serious participant safety events and monitor implementation and effectiveness of corrective action plans.
Conduct quarterly environmental safety rounds of the PACE Center and monitor completion of identified corrective actions.
Coordinate annual transportation safety audits, participant home safety audits, emergency preparedness audits, and life safety inspections.
Assist PACE Manager with monitoring compliance with the PACE Emergency Preparedness Program, including participant accountability, emergency drills, continuity-of-care planning, and emergency communication processes.
Monitor transportation quality indicators, including: Preventable vehicle accidents, Transportation-related injuries, Wheelchair securement events, Missed transportation, On-time performance, Participant transportation complaints and grievances.
Collaborate with Transportation Services, Nursing, Rehabilitation, Social Work, Home Care, Facilities, and the IDT to identify participant safety risks and implement corrective actions.
Monitor completion of required safety education, competency assessments, and regulatory training for PACE staff and contracted transportation providers.
Assist with development, implementation, and annual review of PACE Safety, Risk Management, Emergency Preparedness, and Transportation Safety policies and procedures.
Participate in CMS, DHCS, and regulatory surveys by coordinating documentation, responding to survey requests, and monitoring corrective action plans related to participant safety and risk management.
Maintain safety-related documentation, audit reports, committee minutes, incident investigations, and regulatory records in accordance with organizational policies.
Serve as the Quality Improvement Department liaison for participant safety initiatives and enterprise Risk Management activities.
Monitor, investigate, and track incidents, unusual occurrences, and participant safety events.
Conduct root cause analyses (RCA) and assist with corrective action planning.
Track and trend falls, infections, medication errors, wounds, hospitalizations, emergency department visits, and other quality indicators.
Ensure timely follow-up and resolution of identified quality concerns.
Collaborate with leadership to implement participant safety initiatives.
Coordinate intake, tracking, investigation, and reporting of participant grievances and appeals.
Monitor trends and recommend improvement opportunities.
Prepare monthly and quarterly reports for leadership and committees.
Support compliance with CMS, DHCS, and PACE regulatory requirements.
Assist with the preparation and submission of required quality reports.
Monitor quality reporting deadlines and reporting accuracy.
Maintain documentation supporting regulatory compliance activities.
Assist with audit preparation, response activities, and corrective action plans.
Conduct medical record audits and quality reviews.
Monitor performance indicators and quality metrics.
Assist with utilization review activities.
Track corrective actions and monitor the effectiveness of interventions.
Support infection prevention and control surveillance activities.
Prepare reports and data presentations for: Quality Management Committee, Quality Improvement Committee, Leadership Team, Board of Directors.
Record, maintain, and distribute committee documentation as assigned.
Follow up on action items and quality improvement initiatives.
Provide quality improvement education and support to staff.
Collaborate with interdisciplinary team members to identify opportunities for improvement.
Promote a culture of quality, safety, and regulatory compliance.