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Quality Specialist
3 months ago
Position Title:
Quality Specialist
Status:
Full Time/Hourly
Department:
Quality Improvement/Quality Assurance
Position Reports to:
Quality Improvement/ Quality Assurance Director
Summary:
Clinica Romero seeks a Quality Specialist to link patients to clinic and preventive health services to support overall wellness and ensure continuous improvement in healthcare delivery.
work towards improving quality performance measures for our diverse patient population. Seamlessly integrating the roles of a Patient Navigator and the ability to transition into the QI Coordinator role as needed, this position is uniquely positioned to drive effective patient care
and operational excellence.
Duties and Responsibilities:
Act as a vital liaison connecting patients with various healthcare providers.
Conduct outreach via phone to CMOAR patients eligible for preventive services.
Identify and address patient barriers to care, such as transportation, insurance, and
language, by referring them to appropriate resources.
Schedule appointments for follow up appointments, consults and support services
within established service standards, including dietitians, physician, specialty
departments, etc.
Assist in helping patients arrive at scheduled appointments on time and coordinate
transportation when needed.
Prepare patient summaries for the care team's reference, documenting
recommendations using standardized care protocols aligned with CMOAR guidelines.
Compare health plan data with internal HEDIS data to ensure there are no data gaps
Review EHR chart documentation and submit supplemental data into COZEVA when
applicable
Assists with the preparation and coordination of HEDIS medical record review
Assist QI Coordinator in training of new staff
Assist with projects aimed at improving patient healthcare outcomes and enhancing performance improvement metrics.
Assist with the increase of performance improvement measures by assisting with QI projects.
Follow patients throughout the care continuum and collaborate with inpatient care
management resources
Deliver Weekly, Monthly & Quarterly reports that demonstrate outcomes and
performance improvement activities.
Adhere to established productivity benchmarks.
Attend trainings and learning opportunities that expand content knowledge and best practices
Responsible for outreach efforts to establish and maintain positive working relationships with key departments (physicians, office staff, diagnostic staff, nurses, community organizing, etc.)
Gather comments/information from patients and document appropriately in EMR system
Provide detailed updates or anecdotes regarding the program
Qualifications/Requirements:
Education:
High school diploma or GED is required.
- Medical Assistant certification or pre-med background is required
- Proficiency in Microsoft Office, especially Excel.
- Familiarity with HEDIS measures and UDS.
Technical Skills:
Trained in EPIC or similar electronic health record platforms.
Proficiency in Microsoft Office, especially Excel.
Soft Skills:
Strong problem-solving, decision-making, and critical thinking abilities
Exceptional organizational, written, and verbal communication skills.
Outstanding interpersonal skills, including the ability to maintain strong relationships with the healthcare team, other departments, and external stakeholders.
Demonstrated ability to maintain strict confidentiality.
Language:
Bilingual proficiency in English and Spanish.
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