CARE MANAGER AND QUALITY IMPROVEMENT COORDINATOR

1 month ago


Phillips Ranch CA USA, United States BLEHEALTH, LLC Full time
BLEHEALTH, LLC -

Essential Duties and Responsibilities: include but are not limited to the following functions.


MUST HAVE EXPERIENCE WITH UDS AND HEDIS IF YOU DO NOT HAVE THE EXPERIENCE, PLEASE DO NOT APPLY. 




  • Provide care management services
  • Engage members
  • Perform coordination of care, and transition of care.
  • Connect members with resources.
  • Create reports.

  • Improve and drive Quality Improvement across all areas.



  • Drive to clinic locations

  • Engage in process improvement and work with other departments as needed in order to ensure organization-wide improvement.




  • Develop policies, procedures, and protocols for the department using knowledge of Quality Improvement principles, practices, and procedures.




  • Work directly with the clinic staff in establishing, refining, and implementing developed policies, procedures, and protocols for use in the clinic.




  • Assist with the tracking of all UDS, HEDIS clinical indicators on a monthly basis and reporting these measures to the supervisor.



  • Assist with credentialing of Providers
  • Assist with audit

  • Educate and facilitates the use of the PDSA model.




  • Facilitate CAP as determined by QIC when metrics do not progress toward the target.




  • Monitor effectiveness of implementation.




  • Provide written and verbal reports of findings to QI Director.




  • Maintain written reports of findings and activities.




  • Attend training programs as assigned/approved by supervisor.




  • Attend both internal and external meetings.




Qualifications:


Education:





  • Bachelor’s degree in health sciences, business, healthcare administration, health information management, engineering, or other relevant field.



  • Must know Excel, PowerPoint.
  • Must know how to create a PowerPoint presentation
  • Must know how to use Excel. 

  • Minimum 1 year of work experience in healthcare. 




  • Current CPR certification is required.




 


 


 


 


 


 


 


 


 


 



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