Quality Assurance Coordinator

Central Neighborhood Hlth Fdn•Santa Fe Springs, CA

2d•Onsite

About The Position

Central Neighborhood Health Foundation is a Federally Qualified Healthcare Center (FQHC) committed to the Triple Aim as described by the Institute for Healthcare Improvement. Improving the US health care system requires simultaneous pursuit of three aims: 1) improving the experience of care, 2) improving the health of populations, and 3) reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an "integrator") that accepts responsibility for all three aims for that population. The Quality Assurance Coordinator is responsible for providing initial evaluations and individual, group, couples, and/or family therapy at the assigned CNHF clinic. In addition, therapists will provide behavioral health consultation services to the Primary Care Teams within Pediatric and Adult clinics.

Requirements

Experience with Managed Care/Hospital work experience required
Prior experience performing quality assurance in a healthcare environment
Excellent communication skills – oral & written
Must have excellent interpersonal skills and empathy towards patients, excellent communication skills, critical thinking skills, the ability to handle stressful situations, the capacity to function independently, have varied clinical experience, and the ability to document meticulously.
Excellent organizational and prioritization skills.
Excellent presentation skills
Ability to manage multiple deadlines in a fast-paced environment.
Strong problem-solving, group facilitation, and teamwork capabilities.
Ability to work with and utilize volunteers in a variety of fundraising capacities.
Active participation in a multi-disciplinary team of professionals and volunteers.
Ability to maintain integrity by keeping proprietary and sensitive information confidential.
Ability to respond with sensitivity to people of diverse cultures and various lifestyles.
Willingness to commit to the philosophy and goals of CNHF and work as a team.
Maintains patient, employee, and Foundation confidentiality at all times, discussing patient or employee business only with appropriate parties who have a bona fide need to know; and communicating only the minimum amount of information necessary with respect to protected health information (PHI) as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Nice To Haves

Bachelors Degree or MPH, MBA, or MHA or related master's degree Perferred
Experience in delivering training preferred

Responsibilities

Develop and deliver training and educational tools for both onboarding and ongoing providers and staff.
Create, edit and maintain curriculum for training/learning sessions.
Monitor and improve monthly the Quality metrics for all eligible providers including but not limited to HEDIS, UDS, MU.
Track, manage, document, identify, and report patient data.
Schedule appointments for patients.
Follow up with patients that miss appointments to reschedule.
Work closely with providers and care team members to coordinate patient care.
Prepare reports/deliverables for submission to meet Quality requirements including monthly action plans to participating providers as part of continuous process improvement.
Coordinate peer review.
Facilitate QI efforts utilizing improvement methodologies such as Lean, and provide appropriate education to the provider teams.
Participate in organization-wide Quality Improvement functions as determined appropriate.
Participate in Quality Management team planning meetings as requested.
Utilize a variety of reports to perform QA on all functions within CNHF, providing supervisors with the data needed to have constructive feedback sessions with their staff.
Utilize quality assurance activities to identify opportunities for additional training and/or enhancements to curriculum.
Coordinates assigned quality and process improvement activities which may include process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, and tracking of adverse incidents.
Conducts quality control reviews and internal audits.
Summarizes findings and prepare reports on findings.
Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers.
Supports assigned quality committees and work groups through comprehensive project management ensuring that documentation is accurate and timely, agenda items presented and follow-up actions taken.
Review patient healthcare information and records.
Define the level of care.
Determine the necessity of procedures related to diagnosis, and assess emergency and clinical procedures.
Perform a utilization review.
Conduct clinical and facility audits.
Advise staff and other clinical and non-clinical staff on clinical standards and procedures.
Interacts with physicians, nurses, department managers, supervisors, and other professional/non-professional staff members to provide resource information, resolve infection control problems, and identify new opportunities to improve service and reduce costs.
Perform other duties as assigned.