Quality Assurance Coordinator

Job Description

Job Description

INTRODUCTION:

Central Neighborhood Health Foundation is a Federally Qualified Healthcare Center (FQHC) committed to the Triple Aim as described by the Institute for Healthcare Improvement. Improving the US health care system requires simultaneous pursuit of three aims: 1) improving the experience of care, 2) improving the health of populations, and 3) reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an "integrator") that accepts responsibility for all three aims for that population.

SUMMARY:

Responsible for providing initial evaluations and individual, group, couples, and/or family therapy at the assigned CNHF clinic. In addition, therapists will provide behavioral health consultation services to the Primary Care Teams within Pediatric and Adult clinics.

ESSENTIAL DUTIES AND RESPONSIBILITIES include but are not limited to the following functions:

• Develop and deliver training and educational tools for both onboarding and ongoing providers and staff.

• Create, edit and maintain curriculum for training/learning sessions.

• Monitor and improve monthly the Quality metrics for all eligible providers including but not limited to HEDIS, UDS, MU.

• Track, manage, document, identify, and report patient data.

• Schedule appointments for patients.

• Follow up with patients that miss appointments to reschedule.

• Work closely with providers and care team members to coordinate patient care.

• Prepare reports/deliverables for submission to meet Quality requirements including monthly action plans to participating providers as part of continuous process improvement.

• Coordinate peer review

• Facilitate QI efforts utilizing improvement methodologies such as Lean, and provide appropriate education to the provider teams.

• Participate in organization-wide Quality Improvement functions as determined appropriate.

• Participate in Quality Management team planning meetings as requested.

• Utilize a variety of reports to perform QA on all functions within CNHF, providing supervisors with the data needed to have constructive feedback sessions with their staff.

• Utilize quality assurance activities to identify opportunities for additional training and/or enhancements to curriculum.

• Coordinates assigned quality and process improvement activities which may include process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, and tracking of adverse incidents. Conducts quality control reviews and internal audits. Summarizes findings and prepare reports on findings.

• Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers.

• Supports assigned quality committees and work groups through comprehensive project management ensuring that documentation is accurate and timely, agenda items presented and follow-up actions taken.

• Review patient healthcare information and records.

• Define the level of care

• Determine the necessity of procedures related to diagnosis, and assess emergency and clinical procedures.

• Perform a utilization review.

• Conduct clinical and facility audits

• Advise staff and other clinical and non-clinical staff on clinical standards and procedures

• Interacts with physicians, nurses, department managers, supervisors, and other professional/non-professional staff members to provide resource information, resolve infection control problems, and identify new opportunities to improve service and reduce costs.

• Perform other duties as assigned.

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE:

• Bachelors Degree or MPH, MBA, or MHA or related master's degree Perferred

• Excellent communication skills – oral & written

• Experience in delivering training preferred

• Experience with Managed Care/Hospital work experience required

• Prior experience performing quality assurance in a healthcare environment

NECESSARY SKILLS:

• Must have excellent interpersonal skills and empathy towards patients, excellent communication skills, critical thinking skills, the ability to handle stressful situations, the capacity to function independently, have varied clinical experience, and the ability to document meticulously.

• Excellent organizational and prioritization skills.

• Excellent presentation skills

• Ability to manage multiple deadlines in a fast-paced environment.

• Strong problem-solving, group facilitation, and teamwork capabilities.

• Ability to work with and utilize volunteers in a variety of fundraising capacities.

• Active participation in a multi-disciplinary team of professionals and volunteers.

• Ability to maintain integrity by keeping proprietary and sensitive information confidential.

• Ability to respond with sensitivity to people of diverse cultures and various lifestyles.

• Willingness to commit to the philosophy and goals of CNHF and work as a team.

WORK ENVIRONMENT

Described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Variations in conditions may occur under certain circumstances.

CONFIDENTIALITY

Maintains patient, employee, and Foundation confidentiality at all times, discussing patient or employee business only with appropriate parties who have a bona fide need to know; and communicating only the minimum amount of information necessary with respect to protected health information (PHI) as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

1. AGREEMENT AND ACCEPTANCE

2. I HAVE READ THE ABOVE JOB DESCRIPTION AND FULLY UNDERSTAND THE REQUIREMENTS SET FORTH AND WILL PERFORM ALL DUTIES AND RESPONSIBILITIES TO THE BEST OF MY ABILITY.