Quality Coordinator Lead
Quality Coordinator Lead
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Job Description
The Quality Coordinator Lead is responsible for ensuring that the collection of Healthcare Effectiveness Data and Information Set (HEDIS) and other insurance quality programs are accurate efficient timely and within compliance guidelines. The quality coordinator lead will monitor and report on all activities processes and procedures that are being implemented to ensure a high level of excellence. This position will be responsible for conducting or assisting with regulatory and quality training sessions while preparing and developing internal auditing tools and conducting internal audits and reports. The quality coordinator lead will drive regular inspections through random audits and reviews to ensure that the other quality coordinators are adhering to and meeting set benchmarks.
Candidates must be legally authorized to work in the United States. Please Note: UNLV Health does not provide employment sponsorships or sponsorship transfers for any positions.
ADVANTAGES OF WORKING FOR UNLV HEALTH
- Clinic Hours are Monday through Friday 8AM to 5PM! (Actual hours may vary depending on business need)
- 12 Paid Holidays per year starting with your first day of employment!
- 20 PTO days per year! (Depending on Position)
- 3% 401K Contribution even if you do not contribute!
- Medical Dental and Vision benefits that start the first of the month following your start date!
- And more!
MAJOR RESPONSIBILITIES
The quality coordinator lead will drive quality improvement through building trusting partnerships elevating a culture of change through data driven excellence while improving healthcare quality initiatives. The quality coordinator lead will be responsible for setting strategic goals and carrying out those goals byestablishing and maintaining an efficient and responsive quality team.
HEDIS/Quality Metrics
Research any discrepancies found by reviewing electronic health records (EHR) and any other relevant information
Identify trends and document any errors found such as CPT 2 codes not dropping. Reporting out this information as soon as it becomes available to the Executive Leadership team
Applying structured auditing criteria to the EHR to determine compliance with HEDIS and Quality metrics setting meeting and exceeding those targeted benchmarks
Demonstrate expertise in the requirements and parameters of mandated HEDIS and Quality performance measures
Provide participation program requirements within the EHR and report to the individual departments and executive leadership.
Coordinate monitor and report progress toward completion of quarterly HEDIS/Quality chart abstraction process
Demonstrate a wide knowledge base to all of the payer insurance portals and be the key person for the physician clinics to train best practice for utilizing portals to meet quality metrics by submitting data through the portal sites.
Coordinate HEDIS/Quality processes and establish a plan to improve quality scores. This will include setting strategic goals with targeted benchmarks for not only the lead role but for the other quality coordinators in their role with the understanding that this organization values all quality initiatives
Responsible for data collection from automated and manual sources. This requires the ability to import and manipulate electronic data.
Must be able to work autonomously on assigned projects and be able to provide status reports on a moments notice.
Performs other duties as assigned
Quality Control Audits:
Works with the Executive Director Payers and the departments to report/monitor HEDIS/Quality program requirements and progress weekly/ monthly.
Reviews daily weekly and monthly key metrics to identify trends or areas of focus; works with the Executive Director of Clinical Operations to develop document and implement action plans as appropriate to address issues
Training:
Identifies opportunities for HEDIS/Quality/revenue improvement automation or issue resolution.
Creates and provides data to baseline and drive solution outcomes
Assimilates new staff into the department and provides ongoing training for the existing team
Attends huddles in all of the clinics and provides education that will help build a culture of understanding
Coordinate Workflow:
Provides Executive Leadership with information regarding HEDIS/Quality status reports
Implements improvements in the work process that both improve the efficiency and effectiveness of the physician clinics
Service Excellence:
Treats patients staff and others with dignity respect and fairness
Delivers exceptional customer service during all interactions and will promote the patient experience through utilizing Press Ganey
Serves with compassion and humility acts with genuine care and concern for others
Communicates with honesty and transparency
Works as an effective and cooperative team member
Is receptive to constructive feedback
Contributes to a culture of inclusion
Acts with integrity and ensures that words deeds and actions are aligned
Comply with all departmental and company policy and procedures
Completes any duties and special assignments as requested
EXPERIENCE EDUCATION AND CERTIFICATIONS
Minimum of three (3) years of experience in Healthcare Medical Assistant and/or related field required
The National Association for Healthcare Quality (NAHQ)Certified Professional in Healthcare Quality(CPHQ) certification required within 1 year of hire
High School Diploma or GED equivalency required
Graduate from a recognized Medical Assistant program required
Medical Assistant Certification required (certification must be obtained within 90 days of hire)
Basic Life Support (BLS) Certification required
KNOWLEDGE SKILLS AND ABILITIES QUALIFICATIONS
Intermediate knowledge of medical terminology anatomy and physiology
Intermediate knowledge of Microsoft Office and Google Workspace
Demonstrated proficiency in Microsoft Office (Word Excel etc.) and Google Suite (Gmail Docs etc)
Strong critical thinking and problem solving skills
Excellent verbal and written communication skills
Basic understanding of population health and data analytics
Must be able to work independently with minimal supervision
Must be able to multitask and prioritize work in a fast paced environment
Must be able to maintain confidentiality
Must be able to pay close attention to details and well organized
PHYSICAL REQUIREMENTS
May include standing sitting and/or walking for extended periods
May include performing repetitive tasks
May include working on a special schedule (i.e. evenings and weekends)
May include working with challenging patients and clients
May include lifting up to 25 pounds
UNLV Health will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race color gender age national origin ancestry religion physical or intellectual disability marital status parental status sexual orientation or any other category protected by law.
If you have any questions about our interview and hiring procedures please contact Recruitment at
Required Experience:
IC
Employment Type
Full-Time
