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Ambulatory Quality Improvement Specialist
5 months ago
Job Title: Ambulatory Quality Improvement Specialist
Job Location: Green Valley, CA
Job Duration: 2-3+ Months Contract (Possible Extension)
Pay Range: $23/hr. on W2
Job Description:
· Performs quality functions in support of the ambulatory division.
· Accurately updates patient information in the electronic medical record related to physician assignment, deceased records, multiple missed appointments, and health plan disenrollment related to the daily operations of the practices.
· Reconciles and captures clinical quality documentation.
· Assists with health plan medical record review (MRR) surveys and compiles data for quality measure/health plan reporting.
· Assists with managing the data and clinical quality integrity of the medical record.
· Collaborates with the Manager to enhance quality measure provider and staff training, clinical performance, and process improvement efforts.
· Supports quality operations of the Ambulatory Division providers and clinical staff.
· Processes quality and clinical results data for medical records pertaining to care gap closures, preventive, chronic conditions, and continuity of care.
· Processes medical records and supplemental data and corresponding results in accordance with medical record policies for medical records received from outside facilities, third-party vendors, lab results and other external clinical data (i.e., updating health maintenance, preventive and chronic condition care gaps, lab, and procedure results).
· Utilizes clinical knowledge to review provider and staff documentation and updates medical record data received to ensure compliance with HEDIS and CMS measures through identified through health plan care gap lists.
· Utilizes clinical knowledge of vaccinations and immunization schedules, updates the medical record immunization profiles and California Immunization Registry (CAIR) to accurately reflect immunization compliance.
· Use clinical knowledge and judgment to assess external medical data received for appropriate inclusion in the medical record and supplemental data to health plans.
· Assists managers in identifying, addressing, and resolving patient medical record care gaps and issues; provides corrective feedback to team members when appropriate.
· Utilizes clinical knowledge to perform medical record and immunization review/ audits, in compliance with CDPH, CHDP, and HEDIS reporting requests and requirements.
· Assists in patient outreach and identifying and resolving care gap closure lists in the medical records.
· Performs duties related to policies associated with multiple missed appointments and disenrollment from the ambulatory departments.
