Quality Management Coordinator

As our Quality Management Coordinator, you will assist in the promotion of Quality Management activities related to monitoring, assessing and improving performance in health care delivery and services to plan members.

Every day you will assist in data collection, data entry, record maintenance, chart audits, member mailings, committee facilitation, collaboration with other departments and interaction with contracted health plans. In addition, you will be involved in patient outreach and scheduling.  You will also assist in the coordination, processing and resolution of incoming member appeals and grievances. 

To be successful, you will have an awareness of HEDIS measures, excel in being detail-oriented, and have exceptional communication skills.

As a remote employee, we will provide you with the equipment needed to work from home, including a laptop, docking station, dual monitors, and accessories.

This position will be work from home for CA residents, ideally located within driving distance to the Ventura region, as there will be quarterly onsite presence for chart reviews in the provider offices.

• Perform quality management activities related to data collection, data review, and report preparation per Quality Management Program.
• Assists in the reporting of required quality studies in order to meet contractual requirements.
• Assist in the compilation, organization, and presentation of various committee and quarterly reports.
• Takes notes to compose meeting minutes, tracks and follows up on actions.
• Maintain the confidentiality of records and reports for both the membership and contract providers.
• Create, design, and maintain educational resources and tools.

Required

• Two or more (2+) years experience in an administrative position
• Experience in creating and manipulating data with spreadsheets and/or databases using Excel, Access or other similar programs and/or applications
• Awareness of clinical HEDIS measures
• Ability to learn and use other software such as, QNXT, NextGen, and other electronic medical records
• Ability to navigate through patient information in an Electronic Medical Record (EMR) or a paper medical record
• Must be attentive to detail, accurate, thorough, and persistent in following through to completion all activities, demonstrating initiative for completing work assignments
• Ability to communicate effectively in verbal and written form
• A self-motivator with the ability to function independently in Corporate and Provider offices

Preferred

• Medical Assistant (MA) strongly preferred
• Associates degree preferred
• Experience in medical billing/coding, medical documentation improvement, pay-for-performance or similar programs preferred
• Experience working with physicians offices in regards to coding, documentation or quality measures preferred
• Statistical analysis and database skills preferred

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

One Community. One Mission. One California 

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards.

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.