Provider Network Quality Coordinator
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Job Location:
Somerville, NJ - USA
Hourly Salary:
$ 21 - 31
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham we are on the forefront of transformation with one of the worlds leading integrated healthcare systems. Together we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.Our work centers on creating an exceptional member experience a commitment that starts with our employees. We are pleased to offer competitive salaries and a benefits package with flexible work options career growth opportunities and much more.
Responsible for supporting the provider data quality improvement and compliance initiatives by providing operational assistance. This role involves coordinating quality activities maintaining accurate records preparing reports and facilitating communication across departments ensuring the organization meets regulatory standards and continuously improves provider data quality.
Essential Functions
-Collects organizes and maintains data related to provider data measures audits and performance metrics. Assists in data analysis and interpretation providing administrative support for quality improvement projects.
-Monitors compliance with regulatory standards and reports any discrepancies or areas of concern to the Provider Network Growth team.
-Contact healthcare providers and facilities listed in the provider directory via phone outreach.
-Validate key provider information including: practice name and address phone number office hours whether the provider is accepting new patients languages spoken and network participation
-Document and report findings using internal data collection tools or templates.
-Identify and flag discrepancies or potential directory errors.
-Follow standardized scripts and procedures to ensure consistency and regulatory compliance.
-Work with internal teams (e.g. provider relations compliance) to report trends or escalate issues.
-Maintain a high level of professionalism and neutrality during all interactions.
-Meet established call quotas and documentation deadlines.
Qualifications
Education
High School Diploma or Equivalent required
Associates Degree or Bachelors Degree preferred
Experience
At least 1-2 years of experience in an administrative or support role preferably within a healthcare setting required
At least 1-2 years of experience in quality control assurance accreditation or other related role preferred
Knowledge Skills and Abilities
Familiarity with healthcare quality measures regulatory requirements and accreditation standards is a plus.
Strong organizational communication and interpersonal skills.
Proficiency in Microsoft Office Suite (Word Excel PowerPoint) and data management software.
Ability to handle multiple tasks simultaneously and work effectively in a fast-paced environment.
Additional Job Details (if applicable)
Working Conditions
While a mostly remote role you would attend team meetings every quarter at the office in Assembly Row Somerville
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$21.78 - $31.08/HourlyGrade
4EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.
Required Experience:
IC
Key Skills
- Microsoft Access
- Quality Assurance
- Data Collection
- HEDIS
- ISO 9001
- Root cause Analysis
- Medical office experience
- Quality Systems
- Nursing
- Quality Control
- Quality Management
- Manufacturing
About Company
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.
