Healthcare HEDIS/Quality Operations Coordinator

Regional Quality CoordinatorThe Regional Quality Coordinator role is responsible for managing Quality operational support initiatives while overseeing special projects, with a focus on supporting HEDIS and Pharmacy gap closures. This position requires daily problem-solving, meticulous tracking, and coordination across departments to meet varying and changing requirements. The RQC will oversee assigned affiliate groups, providing Quality operational support to clinics to achieve their goals, which may include engaging with internal and external stakeholders with in-person and telephonic outreach to patients for education and engagement on preventative screenings, data mining, medication adherence, and follow-up with primary care providers. This position may directly interact with patients to complete tasks for quality gap closure.The Regional Quality Coordinator will support the assigned market under the direction of the market VP with the assistance of the National Quality Manager.Essential FunctionsUnderstands the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards, CAHPS, HOS, and HIPAAProvides support to the Quality Management Department by working with members and network providers to improve quality of care through quality activities such as HEDIS, CMS Star Rating, and other quality performance reportingProvides telephonic outreach to patients, providers, and pharmacies to discuss opportunities for optimizing medication use or other opportunities for improvement of healthcare performance measure related issuesImproves patient experience and transitions for better healthcare outcomes through quality careParticipates in data collecting through medical record and claims surveillanceWorks to maximize health plan and healthcare provider performance on healthcare related quality measures through effective telehealth communication with patients and coordination with patient caregivers, providers, and pharmacies.Assists in planning, implementing, and executing projects to improve quality and delivery of care servicesUsing research and knowledge, identifies potential interventions to improve quality strategiesParticipates in Quality Management meetings and other initiativesPrepares quality information for presentation to affiliate groups, including groups current standings relative to others and opportunities or improvementPoint of Contact for provider groups designated by leaderLeads project management of Quality Fairs, Diabetic Days, and P3 events to maximize quality gap closureSubject Matter Expert in P3 machines (diabetic eye camera, bone density machine, etc.)Responds to health plan, provider and interdepartmental calls in accordance with exceptional customer serviceReviews provider group gap uploads through the P3 Provider portalOther duties as assignedEducation and ExperienceHigh school diploma/GED required, associate degree in related field or equivalent experience preferred.2+ years experience in healthcare-related fields required, clinical health care related experience, managed care, or Health plan experience strongly preferred.Experience with Microsoft Word, Excel, Power Point, Outlook and general office equipment such as copier, fax machine, required.Experience in Electronic Health Records required.Medical Assistant Certification or experience as a Pharmacy Tech, Radiology Tech, Lab Tech or similar strongly preferred.Experience with data mining is preferred.Medical terminology knowledge required, experience with CPT II codes preferred.Work ConditionsAvailability to travel within assigned region and work from multiple providers offices as needed.Must have a valid driver's license, safe driving record, and able to furnish reliable transportation.Work Location & ScheduleThis role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.Pay range per hour: $22 - $28 based on experienceAbout P3People. Passion. Purpose.At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.We are looking for a Regional Quality Coordinator. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.