Quality Coordinator

Job Description

Job Description

Full-time
Monday – Friday
8:00 a.m. to 4:30 p.m.

Position Summary

The Quality Abstractor / Quality Improvement Coordinator supports clinic and organizational quality performance by abstracting and validating clinical quality data, submitting/attesting measures through ACO and payer portals, and working directly with providers and clinic staff to close care gaps and improve quality outcomes. This role coordinates quality incentive requirements across multiple programs (e.g., ACO quality reporting, Medicare Advantage, commercial pay-for-performance, HEDIS-like measures, payer gap lists), ensuring accurate documentation, timely submission, and sustained performance improvement. Leads, monitors, and documents clinic QAPI (Quality Assurance and Performance Improvement) activities.

Essential Job Duties

• Quality Data Abstraction & Validation
  • Abstract clinical data from the EHR and other sources (labs, outside records, hospital reports, immunization registry, etc.) for assigned quality measures.
  • Validate measure eligibility, numerator/denominator logic, and documentation requirements.
  • Reconcile discrepancies between EHR documentation and payer/ACO gap lists; coordinate correction workflows.
  • Maintain clear audit trails for submissions, including evidence documents/screenshots where required.
  Portal Management & Quality Program Submissions
  • Manage ongoing work in external portals (e.g., ACO portal, Medicare Advantage plans, QHi, commercial payer quality portals).
  • Submit supplemental data/clinical documentation to close gaps and ensure accurate credit for performed services.
  • Track reporting calendars, submission windows, and program updates; communicate key deadlines to clinic leadership and staff.
  • Ensure timely completion of all assigned quality reporting activities and respond to portal queries/requests.
  Care Gap Closure & Clinic Workflow Support
  • Run and/or interpret care gap lists and quality dashboards; prioritize outreach based on due dates and risk/impact.
  • Partner with nursing/MA teams, care coordinators, and front desk staff to integrate care gap closure into daily workflows (pre-visit planning, standing orders, outreach calls, annual wellness visit optimization).
  • Collaborate with providers to ensure documentation supports measure compliance (e.g., diagnoses captured appropriately, required elements documented, follow-up plans recorded).
  • Support patient outreach processes (letters, calls, portal messages) in collaboration with quality and/or clinic leadership.
  Provider & Staff Education / Measure Coaching
  • Provide one-on-one coaching and quick reference guidance to providers and staff with the best practices for measure requirements and documentation.
  • Create and maintain measure tip sheets, workflows, and “how-to” guides tailored to clinic operations.
  • Participate in huddles or monthly Quality Council meetings to review progress, barriers, and next steps.
  Performance Monitoring & Reporting
  • Maintain internal trackers for assigned measures, including performance trends, gap volume, closure rate, and submission status.
  • Prepare routine reports for leadership (weekly/monthly) on progress, barriers, and recommendations.
  • Identify patterns impacting performance (workflow gaps, documentation gaps, coding issues, scheduling barriers) and propose solutions.
  Compliance, Confidentiality & Audit Readiness
  • Ensure all quality abstraction and submissions comply with HIPAA, organizational policies, and payer/ACO requirements.
  • Support audit readiness by maintaining documentation and evidence of submitted data and workflows.
  • Report any suspected compliance issues or data integrity concerns to leadership promptly.
  Quality Improvement (QI) Initiatives
  • Monitor and document clinic QAPI (Quality Assurance and Performance Improvement) activities.
  • Coordinate and support quality improvement projects focused on improving patient outcomes, workflow efficiency, and regulatory compliance.
  • Utilize recognized improvement methodologies such as Plan-Do-Study-Act (PDSA) cycles.
  • Facilitate/lead and document DO-IT and PACE projects by identifying improvement opportunities and implementing process changes.
  • Track improvement initiatives and measure effectiveness through data analysis.
  • Prepare annual clinic quality report for Quality Council.
  Other Duties
  • Support related quality improvement initiatives as assigned (e.g., clinical preventive care campaigns, chronic disease registries, annual wellness visit improvement).
  • Perform other duties consistent with the role.
  Knowledge, Skills, and Abilities
  • Strong understanding of clinical documentation and workflows in an ambulatory/RHC setting.
  • Excellent attention to detail and ability to interpret measure specifications and documentation requirements.
  • Highly organized; able to manage multiple portals, deadlines, and competing priorities.
  • Strong communication skills—able to build trust with providers and staff and deliver feedback constructively.
  • Intermediate-to-advanced computer skills (Excel, Teams/SharePoint, EHR reporting tools).
  • Ability to work independently with minimal supervision while escalating risks appropriately.
  Required Qualifications
  • High school diploma or equivalent required.
  • 2+ years in healthcare clinic setting OR quality/registry/abstraction experience preferred.
  • Experience with EHR documentation review and clinical data abstraction.
  • Demonstrated proficiency using web-based portals and spreadsheets for tracking/reporting.
  • Valid driver’s license.
  Preferred Qualifications
  • LPN, CMA, RN, CPC, CPHQ, or other healthcare backgrounds are strongly preferred.
  • Experience with ACO quality programs and payer incentive models (Medicare Advantage, commercial P4P).
  • Familiarity with measure types such as preventive screenings, chronic disease management, immunizations, AWV, and documentation-based measures.
  • Experience with HEDIS-like measures, MIPS concepts, risk adjustment documentation, or population health tools.
  • Experience building standard work, tip sheets, or training materials.
  • Experience with QAPI frameworks and process improvement models.

Benefits

We offer a complete, comprehensive benefit package that includes:

• Health
• Dental
• Vision
• Life
• Retirement Savings with Employer Match
• Health Savings Accounts, with Employer Match
• Flexible Spending Accounts, Medical & Dependent Care
• Supplemental Coverages including Short Term & Long Term Disability, Accident, Hospital Confinement, Cancer
• Paid Time Off
• Employee Assistance Program
• And most importantly, we offer a flexible work environment that supports a healthy work-home life balance.