Quality Management Coordinator I or II

Job Description

Job Description

POSITION SUMMARY 

The Quality Management Coordinator I/II manages health plan gap reports and supports the Quality team in closing care gaps and improving STARs quality outcomes. The Coordinator I focuses on gap analysis and supplemental data and works closely with the Quality Performance Supervisor. The Coordinator II takes on a more provider-facing role, working with the Quality Management Specialists to deliver monthly gap reports and PCP scorecards and communicating with providers to close gaps and support quality patient care. Level will be determined based on experience.

RESPONSIBILITIES-DUTIES 

All Levels

• Perform health plan gap analysis and manage health plan gap reports
• Submit supplemental data to health plans and enter supplemental data in Patient Center
• Process pharmacy and lab data
• Assist in the annual wellness form workflow in OnBase and Ezcap
• Participate in work groups and health plan meetings
• Demonstrate and maintain current working knowledge of the required AMM systems
• Reports to the Director of Provider Network
• Perform other duties as assigned

Additional for Coordinator II

• Perform medication adherence calls
• Run gap reports and PCP scorecards and provide them to assigned providers
• Communicate with providers to actively close gaps in care
• Assist in coordinating system enhancements and report generation to improve STARs quality outcomes
• Participate in and/or coordinate interdepartmental projects, building strong working relationships with internal and external stakeholders

JOB REQUIREMENTS

• Coordinator I:  AA degree OR two years of experience OR a combination of education and experience
• Coordinator II:  Minimum of 1 year of experience in managed care or health care
• Experience in managing projects from start to finish
• Ability to work on multiple projects simultaneously
• Self-starter with excellent problem solving, decision making and follow through skills 
• Valid driver’s license
• Knowledge of quality performance measures and requirements
• Demonstrates technical and operational knowledge and expertise
• Cultivates positive professional and interpersonal relationships with health plans
• Effective organizational skills

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!