Quality Coordinator

2 weeks ago

Riverside, United States Riverside Medical Clinic Full time

**Responsibilities**:
**Come and join the RMC Family**

We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare.

Riverside Medical Clinic is the best place to work, practice medicine, and receive care.

**SUMMARY**: This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS / Star technical specifications for medical records. Other duties within the QM department may be assigned to the QM Coordinator based on department needs.

**QUALIFICATIONS**: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

**HOURS**: Monday - Friday, 830a - 530p

Qualifications:
**EDUCATION and/or EXPERIENCE**: High school diploma or GED required. Preferably two to three (2-3) years’ experience in the healthcare field. Associate’s degree preferred.

**CERTIFICATES, LICENSES, AND REGISTRATIONS**: None.

**ESSENTIAL FUNCTIONS**:
Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Note: (other duties may be assigned, deleted or changed at any time, at the discretion of management, formally, or informally, either verbally or in writing).

1. Work closely with health plan partners to close HEDIS measure care gaps.

2. Process grievances, appeals and complaints.

3. Complete Peer Review Evaluations, initiate Provider Medical Record Audits, and process incident reports.

4. Report hospital transfers from ASC based on regulatory requirements. Analyze data and conduct root cause analysis.

5. Complete data entry in an accurate and timely manner.

6. Maintain the privacy of both internal and external clients.

**OTHER RESPONSBILITIES**:
1. Uphold and support the mission, philosophy, objectives, and policies of Riverside Medical Clinic.

2. Assume responsibility for initiating a pleasant patient-oriented atmosphere by displaying a professional attitude through performance, appearance, and demeanor.

3. Maintain work area in a clean and orderly manner and in accordance with facilities policy.

4. Annually participate and complete required health screening.

5. Adhere to Safety Program as outlined in Core Competencies and Injury, Illness and Prevention Program.

6. Maintains professional composure and confidence during stressful situations.

7. Maintains open communication using appropriate chain of command regarding issues.

8. Presents neat appearance in proper attire and identification as required by the position, department and RMC policy.

9. Continuously displays a positive, “can do” attitude within the department and across departmental lines to contribute to the overall customer service program in place at Riverside Medical Clinic.

**Benefit Highlights**:
Challenging and rewarding work environment.

Competitive compensation and paid time off.

Excellent Medical, Dental, Vision and Life Insurance Plans.

401(K) with company match and discounted stock plan.

**EEO Statement**:
We believe that diversity and inclusion among our teammates is critical to our success.

**Notice**:
**Salary**: Starting from $17.50 to $30.06 an hour

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