Quality Improvement Coordinator I

Call the Car•Diamond Bar, CA

just now•Onsite

About The Position

Under the guidance of the Quality Improvement Supervisor, the Quality Improvement Coordinator I provides essential support to the Quality department by assisting with the intake, documentation, and tracking of grievances, accidents, incidents, injuries, and reimbursement requests. They may assist with the dissatisfaction process, ensuring member concerns are handled in accordance with contractual and regulatory guidelines. This entry-level position also ensures that all cases are accurately recorded, tracked, and processed in a timely manner in accordance with CTC policies and regulatory requirements. The role also supports investigations by gathering data, collaborating with internal teams, and maintaining record accuracy. Additionally, they assist with researching and identifying trends to contribute to ongoing quality and process optimization efforts.

Requirements

At least 1–2 years of relevant Administrative or Customer Service experience; experience in a healthcare, transportation, or quality improvement setting preferred.
Associate’s degree preferred; High School Diploma or GED required.
Proficiency with Microsoft Office (particularly Excel, Outlook, and Word) required.
Experience with case management or dispatch.
Possesses organizational skills with close attention to detail.
Strong verbal and written communication skills with the ability to interact collaboratively with team members and professionally with external contacts.
Ability to adapt quickly to changing priorities and handle multiple tasks simultaneously.
Strong problem-solving and critical thinking skills, along with the ability to multitask and manage time well in a fast-paced, team-oriented environment.
Basic knowledge or willingness to learn CTC systems and procedures, including but not limited to CTC Connect, dispatch software, customer service protocols, and client expectations.
Advanced analytical skills -- ability to make recommendations by using data to identify trends.
Comfortable working independently with guidance from management.
Ability to type at least 40 wpm.
Must pass a Criminal Background Screening and Drug Screen.
Must pass government exclusion list at time of hire and monthly thereafter.

Nice To Haves

Familiarity with Google Workspace (Docs, Drive, Sheets, etc.) and SharePoint are a plus.

Responsibilities

Assists with the intake, documentation, and processing of grievances, complaints, accidents, incidents, injuries, reimbursement requests, and dissatisfactions in accordance with internal policies and applicable regulatory guidelines.
Expects to be assigned and resolve at least eight (8) grievance cases per day, or as required by operational needs, while maintaining accuracy, timeliness, and compliance.
Accurately logs and updates cases in internal databases and systems, such as CTC Connect, ensuring all entries are complete, timely, and properly categorized.
Supports the grievance resolution process by gathering documentation, communicating with involved parties, and drafting or assisting with resolution letters as assigned.
Participates in cross-training to handle all case types (e.g., grievance intake and responses, accidents, incidents, injuries, reimbursement requests, and dissatisfactions), ensuring readiness to support any area as assigned by the leadership team.
Assists with researching and preparing information for case investigations, under the direction of the Quality Improvement Supervisor or Manager.
Responds to internal and external inquiries professionally and in a timely manner, escalating complex issues to the Supervisor or Manager as appropriate.
Supports daily monitoring of inboxes to ensure timely intake and incoming case assignment.
Collaborates with team members and other departments to ensure grievances and complaints are addressed promptly, fairly, and consistently.
Uses Excel to maintain logs, track case statuses, and support productivity reporting.
Participates in regular quality audits or spot checks of case documentation, as directed, to maintain compliance with documentation standards.
Ensures all assigned tasks and cases are completed in accordance with department timelines and quality expectations.
Assists in preparing reports related to trends/caseloads for review and leadership updates.
Handles confidential or sensitive information regarding members, vendors, or internal staff.
Attends required training and actively participates in coaching sessions to improve job performance and understanding of policies and procedures.
Adheres to all Desk Level Procedures (DLPs), company policies, and relevant regulatory requirements related to grievance handling and quality assurance.
Supports continuous improvement efforts by identifying potential issues and offering suggestions to streamline processes or improve service quality.
Performs all other duties and supports special projects as assigned by management.