The Quality Coordinator is responsible for ensuring that the collection of Healthcare Effectiveness Data and Information Set (HEDIS), and Quality programs are accurate, efficient, timely, and within compliance guidelines. While ensuring FOS or MA roles are met.
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
Ensures processes for obtaining quality data in support of each payer contract/agreement with duties including but not limited to:
- HEDIS/Quality
- Research any discrepancies found by reviewing medical records and any other relevant information
- Identify trends and document any errors found
- Applying structured auditing criteria to medical records to determine compliance with HEDIS and Quality standards
- Demonstrate expertise in the requirements and parameters of mandated HEDIS and Quality performance measures
- Provide participation program requirements within electronic health records and report to departments and leadership.
- Coordinate, Monitor, and report progress toward completion of the annual HEDIS/Quality chart abstraction process
- Understand and have access to payer insurance portals
- Coordinate HEDIS/Quality processes and establish a plan to improve scores
- Implement a process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
- 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 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
- Coordinate Workflow:
- Provides Executive Director of Clinical Operations and company leadership with information regarding HEDIS/Quality/Accounts Receivable and/or departmental performance
- Develops and presents information to leadership
- 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
- 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
Educational Requirements
- High School Diploma or equivalency
- Graduation from a Medical Assistant program required
Qualifications
- At least three years of healthcare experience required
- Must possess the following above-average skills in, but not limited to, verbal, writing/composing, correspondence/reports, analytical and design
- Medical Terminology, anatomy, and physiology
- Microsoft Office knowledge
- Must be well organized and detail-oriented
Physical Requirements
- May include standing, sitting, and/or walking for extended periods
- May include performing repetitive tasks
- 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 healthjobs@medicine.unlv.edu
