Clinical Quality Improvement Coordinator I 211125
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Job Location:
Tallahassee, FL - USA
Monthly Salary:
Not Disclosed
Posted on:
3 hours ago
Vacancies:
1 Vacancy
Job Summary
Title - Quality Improvement Coordinator II 211135
Duration - 3 months
Shift - Training M-F 8-5p 1on1 setting 4 weeks no time off M-F 8-5p AZ
Location - Remote -AZ
Core responsibilities include:
Conduct review of delegated entities for compliance with quality service performance and utilization credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communication with agencies and providers. Collaborative culture. Key project to complete AHCCCS Medicaid QOC investigations.
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Receive 1-2 QOC investigations daily that are due 60 days from the assignment date. Reviewing medical records provider policies/manuals and statutes to ensure providers are rendering appropriate care to our members per the guidelines. Writing an investigative report of findings and submitting reports.
Expectation to complete 1 investigative report per day. The role is unique as it requires clinical knowledge to be able to identify quality concerns and develop quality improvement plan to address the concerns with the provider.
Education/Certification Required:
High School diploma
Years of experience required:
3 years of clinical quality improvement or healthcare experience. MUST have BH or physical health setting experience.
2 years of experience in quality function in a healthcare setting.
Disqualifiers:
No clinical BH or physical health experience
Top 3
Clinical knowledge
Critical thinker independent work tech savvy
Self-driven
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
