Quality Enhancement Specialist II (QI2602 - NIC)

CommuniCare Health Center Jobs•San Antonio, TX

7d•Onsite

About The Position

The Quality Enhancement Specialist II is responsible for assisting in the direction and coordination of quality improvement activities and projects across the organization to create a culture of continuous process improvement. Works closely with clinical staff in the optimization of workflows for Center practices as they make the transition to value-based, population health payment models. The goal is to help providers measurably improve quality scores through improved training, workflows in offices, and data capture.

Requirements

High School graduate or equivalent
Three years of experience working in a healthcare setting within a Quality or Clinical area is required
Assists with team with managing projects
Detail-oriented person with experience in collection and interpretation of data and experience with quality improvement principles is preferred
Must have a high regard for confidentiality
Demonstrated strong organization, interpersonal and communication skills
Must have excellent written and oral communication skills and the ability to prioritize and handle a variety of tasks simultaneously
Project Management experience preferred
Computer literacy with extensive knowledge of spreadsheets and graphs
Must have reliable transportation to perform clinical site audits within Bexar, Kendall and Hays counties.

Responsibilities

Supports multiple performance improvement teams to collect data, monitor progress and report on multiple preset measures to meet targets for improvement.
Review varied clinical performances, effect changes as needed to improve services, simplify workflow and assure compliance with regulatory requirements.
Creates and maintain databases as needed for compliance, quality improvement, utilization management and risk management processes. Prepares, maintains and runs reports. Assist with patient health and wellness program awareness and screening opportunities as needed.
Collaborates with Quality Improvement Initiatives and investigate irregularities and policy violations.
Assure compliance with established standards and regulatory requirements within the clinical setting.
Value Based Care and Accountable Care Organization-related functions; to include clinical outcome metrics review, personal health assessment, collaboration with Population Health Team and Value Based Health initiatives. Collaborates with hospital for timely notification of ER visits, hospital admissions and discharges. Collaborates with sub-acute facilities for beneficiary admission, status and discharge planning, and any other administrative activities related to the overall clinical care improvement of members.
Maintain professional growth and development.
Communicates and applies QA/PI Program standards, procedures and goals.
Actively participate in the QA/PI team-orientated decision-making process. Is a team player, willing to be flexible and open to other’s ideas.
Develop a proactive mind-set toward the job. Observes opportunities for improvement, formulates ideas, communicates those ideas with the Quality Manager and/or other staff, carries out variations in work habits in continuous quality improvement.
Maintains privacy and confidentiality with regard to all patient, staff and agency information.
Provides excellent internal/external customer service via telephone, fax or face-to-face contact to assist patients with their health care needs.
Performs other related duties as assigned.