Quality Coordinator

Job Summary  

General responsibilities of a quality coordinator are to provide quality support of the clinic team and patients; ensure medical records remain up to date; and the clinic meets regulatory and quality record standards and resolves any issues or discrepancies as they arise.  

In this role the coordinator will be expected to perform audits on all medical records; and review the data to ensure records are accurate as well as being able to assess the quality of patient care. It is crucial for the Quality Coordinator to have knowledge of CMS stars rating process, Medicaid Quality measures programs and clinical standards and outcomes. 

Essential Job Functions  

Daily review of and prepare for the next day of assigned provider's Cap patients. 

Daily review of quality in medical records, update records accordingly to aid preparing for the next day patient visits. 

Responsible for coordination of care regarding quality gaps measures pending with our office managers and QI director. 

Responsible for coordination of any quality gaps measures events with QI director. 

Responsible for coordination of quality chart review requests from insurance companies, document, and follow-up with insurance companies. 

Responsible to coordinate with clinic administrators regarding medical records from hospitals, specialist visits and/or SNH for office follow-up missing in a chart. 

Identify and follow up with errors regarding billing or medical assistant's documentation detailing quality measures. 

Send to QI Director Spreadsheet (is this OFP only?) report on time for process. 

Responsible for keep our EHR/EMR system (example, eCW, NextGen) up to date as: 

• Identified and correct any patient's information error. 

• Quality Spreadsheet 

• CDSS/Alerts 

• Quality Global Alerts 

• Arcadia Quality Measures Portal. 

Minimum Required Education, Experience & Skills  

• Must complete at least a two-year associates degree through a technical school or community college. 

• Two years of EHR/EMR system experience (eCW, Next Gen preferred). 

• 1-2 years healthcare experience – as a quality coordinator preferred. 

• One year Stars Rating/Medicaid quality measures experience. 

Preferred Education, Experience & Skills 

• Relationship Management skills. 

• Effective written/verbal communication. 

• Ability to effect or advocate for change. 

• Perform critical clinical analysis. 

• Plan and organize effectively reports.