Clinical Quality Coordinator

Applicants must apply with an active current email and phone number.

Hale County Health Care Authority is a certified drug-free workplace. All potential new hires must undergo a background check and drug screening before employment.

Location:

Hale County Hospital Clinic

508 Greene StreetGreensboro AL 36744

Normal Hours:

Monday-Friday from 8AM-5PM

Classification:

Full-Time; 40 hours a week

This job description covers the most significant duties performed but does not exclude other work assignments not mentioned.

SUMMARY

The Clinical Quality Coordinator is responsible for supporting and coordinating clinical quality improvement activities across the organizations outpatient clinics: Hale County Hospital Clinic & Moundville Medical Associates. This position works closely with providers nurses medical assistants registration staff clinic leadership administration and insurance payer representatives to identify and close gaps in care improve preventive and chronic-care measures and support accurate clinical documentation.

This position requires a Licensed Practical Nurse (LPN) or Certified Medical Assistant (CMA) with strong clinical knowledge excellent organizational skills and experience working with electronic health records patient data quality measures and insurance-related clinical initiatives. The ideal candidate must also be highly proficient in Microsoft Excel and comfortable managing large patient lists reports spreadsheets and multiple payer portals.

PRIMARY RESPONSIBILITIES

Clinical Quality & Gaps in Care

• Monitor quality measures and care gaps across Medicare Advantage Medicaid commercial insurance and other applicable patient populations using payer reports dashboards and electronic health records.
• Identify outstanding preventive and chronic-care needs including wellness visits cancer screenings diabetes care kidney health blood pressure control medication reconciliation and immunizations.
• Track completion and documentation of ordered screenings testing referrals and other services; investigate discrepancies and obtain outside records to verify completed care.

Payer Quality Programs & Insurance Portals

• Serve as a resource for payer quality initiatives participate in payer meetings prepare relevant reports and track follow-up items.
• Navigate insurance portals to review patient quality information and upload records or supporting documentation for gap closure.
• Review provider rosters and patient attribution lists addressing discrepancies with the appropriate payer.

Electronic Health Record & Documentation

• Use AthenaOne or the designated electronic health record to review patient charts and reconcile clinical information with payer quality reports.
• Identify missing incomplete or incorrect documentation and guide staff on appropriate structured documentation to accurately capture completed services.

Pre-Visit Planning & Clinical Staff Support

• Coordinate quality-focused pre-visit planning review upcoming schedules and provide care-gap information to clinical staff.
• Work with nurses and medical assistants to incorporate quality opportunities into routine chart preparation.
• Educate staff on quality measures documentation payer requirements and workflows; develop resources and provide individual assistance as needed.

This position supports educates and monitors the quality process while each providers assigned nurse or medical assistant remains responsible for routine chart preparation triage and clinical duties.

ADDITIONAL RESPONSIBILITIES

• Maintain accurate patient rosters quality reports and outreach lists in Microsoft Excel; reconcile multiple data sources remove duplicates and update completed measures and inactive patients.
• Coordinate with registration staff clinical staff and providers to support patient outreach and scheduling for wellness visits preventive care screenings testing referrals and follow-up appointments.
• Track outreach attempts responses appointments outcomes and care-gap status; identify barriers to care and communicate recurring concerns to leadership.
• Use Excel formulas calculations tables and charts to analyze performance and maintain monthly and year-to-date tracking of quality measures outreach and improvement efforts.
• Monitor performance by clinic provider payer and measure; assist with improvement initiatives and track progress toward quality goals.
• Conduct periodic chart reviews and audits to validate documentation identify missed opportunities and determine follow-up or staff education needs.
• Prepare quality summaries and reports for providers leadership Administration and Quality/QAPI committees; maintain supporting records for quality improvement activities.
• Perform other duties and special projects as assigned by clinic leadership or Administration.

QUALIFICATIONS

• Current Licensed Practical Nurse (LPN) license OR Certified Medical Assistant (CMA) credential.
• CPR/BLS certification preferred.
• Strong proficiency in Microsoft Excel is required including the ability to confidently sort and filter data manage multiple worksheets work with large spreadsheets compare data create basic formulas calculate percentages and organize information for reporting.
• Strong understanding of medical terminology and common preventive and chronic-care services.
• Ability to interpret reports investigate discrepancies and follow an issue through resolution.
• Ability to maintain HIPAA compliance and appropriately handle confidential patient and insurance information.

KNOWLEDGE AND SKILL REQUIREMENTS

• Experience working with electronic health records; AthenaOne experience is strongly preferred.
• Previous experience in a physician office outpatient clinic medical practice healthcare quality care coordination population health or similar healthcare setting.
• Ability to manage multiple ongoing projects and patient lists recognize discrepancies in clinical and payer information communicate effectively with clinical and administrative staff

WORKING CONDITIONS

• Classification Category I Tasks that involve exposure to blood bodily fluids or tissues.
• Normally works in a well-lighted well-ventilated area.
• Frequently requires sitting with occasional lifting of up to 15 lbs; may require occasional lifting of more than 15 lbs.

Required Experience:

IC