Clinical Quality Coordinator

Job Description

Job Description

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision: a community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an organization you would like to be a part of, we would love to meet you.

Under the direction of the Quality Leadership Team, the Clinical Quality Coordinator supports clinical and administrative tasks assigned to improve quality performance and maximize incentive opportunities for Medicare members. This is a full-time, hybrid position. Schedule: Monday-Friday, 8am-5pm.

Responsibilities

• Perform outreach to schedule Medicare members for preventative visits and screenings
• Perform eligibility verification to ensure compliance with CMS billing requirements for Medicare preventative visits
• Perform pre-visit chart preparation and health risk assessments
• Perform post-visit documentation audits to facilitate accurate payor requirement submissions
• Provide feedback to care teams and facilitate corrections to ensure documentation supports billing codes
• Coordinate training for medical assistants and outreach staff to support preventative visits and services for Medicare members
• Function as a resource person for Site Leadership regarding Medicare preventative service guidelines
• Provide MA coverage for Medicare preventative visits

Quality Management

• Assist in development and implementation of workflows related to quality programs and quality improvement projects.
• Research and compile information as needed for planning and organization of quality improvement projects. Prepare agendas, take minutes, and follow up on action items for meetings
• Contribute to the success of the organization by participating in quality improvement activities
• Research and compile business-related information for quality incentives and special projects
• Collect and compile health plan scorecards and internal analytics reports
• Run reports and obtain data from the EMR system and analytics
• Work closely with the Analytics Department to ensure accuracy of reports

Medicare Annual Wellness Visits (AWV)

• Assists with the implementation and creation of workflows pertaining to the scheduling team, clinical team, and other departments that support in the completion of these visits
• Help gather the requirements for documentation, coding, and submission of completed AWVs
• Leads and monitors productivity and quality metrics for the department/specific teams and works with department and sites on improved strategies
• Serves as a liaison between the health plans, Medicare, and Neighborhood Healthcare to keep track of updates to AWV requirements and to communicate them within organization
• Tracks outreach efforts and number of completed, submitted, and credited AWV visits

Qualifications

Education/Experience

• High School diploma or GED required
• Valid Medical Assistant Certificate from an accredited program required
• Two years of medical assistant experience required
• Current Basic Life Support (BLS) certification is required upon hire and must be maintained as a condition of employment. These courses must follow AHA guidelines but may be completed through approved online providers such as ProMed or other equivalent programs that meet recognized BLS standards

Additional Qualifications (Knowledge, Skills and Abilities)

• Strong communication and leadership abilities
• Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
• Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
• Ability to successfully manage multiple tasks simultaneously
• Excellent planning and organizational ability
• Ability to work as part of a team as well as independently
• Ability to work with highly confidential information in a professional and ethical manner
• Ability to work under pressure and be flexible with changing site needs. Can work with people of all social and ethnic backgrounds and maintain confidentiality. Able to train and manage staff in a collaborative manner

Physical Requirements

• Ability to lift/carry 20lbs/weight
• Ability to stand for long periods of time

Neighborhood Healthcare offers a generous benefit plan that includes: Partially company paid Medical, Dental, and Vision Plans. Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more!

Pay range: $27.21-$38.10 per hour, depending on experience.

Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.