Clinical Quality Specialist

2 weeks ago

Conshohocken, Pennsylvania, United States Tandigm Health Full time
Clinical Quality Specialist - Temporary (local remote)

Tandigm Health, a pioneering organization in population health management, is seeking a Clinical Quality Specialist - Temporary. We are committed to fostering a diverse and inclusive workplace and offer a competitive compensation and benefits package.

Key Responsibilities:

OVERVIEW:

As a Clinical Quality Specialist (CQS), you will play a vital role in our Clinical team, focusing on patient outreach regarding medication adherence and quality improvement initiatives. Your responsibilities will include collaborating with practice staff, analyzing patient demographic and clinical information, conducting outreach calls, assisting with patient scheduling, and documenting outcomes. Additionally, you will support various quality-related projects and administrative tasks to enhance the effectiveness of the quality team.

PRIMARY DUTIES:
  • Exhibit exceptional behavior and communication skills that reflect Tandigm Health's dedication to outstanding customer service, emphasizing quality and care for both internal and external stakeholders.
  • Work closely with the clinical quality team and practice personnel to ensure patient outreach and coordination are conducted with professionalism and accountability.
  • Engage with patients to promote medication adherence by identifying barriers, providing education, and facilitating necessary actions.
  • Coordinate follow-up actions with primary care practices and pharmacies on behalf of patients.
  • Occasionally conduct outreach related to preventive care, such as cancer screenings or diabetes management, and arrange necessary appointments.
  • Accurately document patient interactions with meticulous attention to detail, utilizing relevant platforms and Excel.
  • Communicate effectively and promptly with all stakeholders, including members of the Quality and PHSO teams, medical directors, and office staff.
  • Develop a strong understanding of clinical and medical terminology relevant to the patient population.
  • Identify opportunities for collaboration with primary care providers, specialists, or clinical quality nurses to address complex patient needs and leverage community resources.
  • Act as a resource for colleagues, addressing issues and responding to requests efficiently.
  • Provide guidance and support to primary care offices in establishing effective processes to achieve high-quality performance metrics.
  • Input data into electronic medical records or quality platforms as directed.
  • Perform administrative tasks to enhance the overall efficiency of the quality team.
  • Safeguard and manage patients' protected health information (PHI) in compliance with HIPAA standards.
  • Undertake additional responsibilities as assigned.
Qualifications:

EDUCATION:

Minimum: High school diploma, G.E.D. or equivalent.

Preferred: Associate's or Bachelor's Degree.

EXPERIENCE:

Minimum: 3 years of professional experience in a healthcare setting, such as a physician practice, hospital, pharmacy, or health plan. 3 years of experience in a customer-focused environment.

ESSENTIAL SKILLS AND ABILITIES:
  • Excellent interpersonal skills; ability to engage and motivate patients, physicians, and office staff over the phone.
  • Highly organized, detail-oriented, and accurate.
  • Self-driven and proactive; responds promptly to requests.
  • Demonstrated success in managing projects and responding to customer needs.
  • Strong decision-making skills and the ability to work independently while collaborating with internal and external customers.
  • Customer-service oriented; respectful and responsive to all stakeholders.
  • Outstanding communication skills; capable of representing the organization with confidence.
  • Collaborative and resourceful; able to work effectively in a team and independently.
  • Proficient in Microsoft Office and electronic medical records.
  • Skilled in using web-based applications and office equipment.
  • Typing speed of at least 45 wpm.
  • Familiarity with medical and pharmacological terminology.
  • Understanding of Stars and HEDIS measures.
  • Knowledge of HMO/managed care/health plans.
COVID-19 Requirements:

Candidates must provide proof of full COVID-19 vaccination upon employment. Reasonable accommodations will be considered on a case-by-case basis in accordance with applicable law.

Equal Employment Opportunities (EEO):

Tandigm provides Equal Employment Opportunities (EEO) to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, or genetics.

Search Firm Representatives Please Read Carefully:

Tandigm Health, LLC does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

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