Healthcare Quality Coordinator

4 weeks ago


Orange, California, United States Eastridge Workforce Solutions Full time

Eastridge Workforce Solutions is a leading provider of workforce management solutions, committed to connecting skilled professionals with meaningful career opportunities. We are currently seeking a Quality Care Coordinator to join our team.

Job Responsibilities
  • Manage assigned member outreach by closing gaps in care and increasing HEDIS/IHA/STAR/P4P scores.
  • Receive inbound calls from members and assist with tracking data.
  • Document details of healthcare provider activities in quality platforms for accurate tracking.
  • Provide education to encourage staff and providers to complete required quality measures.
  • Input alerts in EMR to notify providers of outstanding items due for completion.
  • Develop and maintain P4P and HEDIS training manuals and documentation.
  • Assist in the coordination and preparation of HEDIS medical record reviews.
  • Provide members with information about contracted lab locations.
  • Support accreditation activities such as NCQA reviews, CAHPS, and state audits.
  • Ability to create CMS1500 forms and discuss coding with providers.
  • Request medical records from healthcare providers to verify services.
  • Follow departmental policies and procedures for audit compliance.
  • Assist outside departments with facilitating PCP transfers and answering questions.
  • Populate the database with new member demographic information.
Qualifications
  • Minimum Education: High School Diploma or GED required.
  • Minimum Experience: A minimum of three plus years of IPA/HMO experience and one plus year in P4P/HCC/CMS Star Programs experience.
  • Ability to project excellent customer service, negotiation, and conflict resolution skills via telephone.

Eastridge Workforce Solutions is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.



  • Orange, California, United States Newport Healthcare Full time

    Job DescriptionAs a Behavioral Health Care Coordinator at Newport Healthcare, you will play a vital role in the care and support of adolescents in our residential program.Key ResponsibilitiesProvide supervision and support to clients, ensuring their safety and well-being.Facilitate daily schedules, including activities, chores, and meal service.Communicate...


  • Orange, California, United States University Of California Irvine Full time

    Position Summary:As a key member of the UCI Health leadership team, the Chief Quality Officer, Vice President will be responsible for developing and implementing a comprehensive quality and safety strategy that aligns with the organization's mission and goals.The ideal candidate will have a strong background in healthcare quality and safety, with experience...


  • Orange, California, United States University Of California Irvine Full time

    Overview:UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County.The Comprehensive Epilepsy Program at UCI Health is a multidisciplinary team of healthcare professionals dedicated to providing high-quality, individualized care for patients with epilepsy.We are seeking a highly...


  • Orange, California, United States Gentle Dental Full time

    About Gentle DentalWe are dedicated to providing exceptional, lifelong, integrated oral healthcare services that enhance the quality of our patients' lives. Our commitment to patient care, operational and clinical excellence, personal accountability, building relationships, and seeking out innovative approaches is paramount to our success.Treatment...

  • Healthcare Manager

    4 weeks ago


    Orange, California, United States Orange HC, CA-ORG Full time

    Job Title: Healthcare ManagerOrange HC, CA-ORG is seeking a highly skilled Healthcare Manager to join our team. As a key member of our healthcare team, you will be responsible for managing the delivery of high-quality patient care services in a fast-paced environment.Key Responsibilities:Manage the planning, development, and implementation of healthcare...


  • Orange, California, United States Zachry Group Full time

    Job Summary:As a Quality Piping Inspector II at Zachry Group, you will play a crucial role in ensuring the quality of piping systems on our projects. Your primary responsibility will be to perform visual inspections of piping systems, in-progress inspections to ensure quality, and record the results of tests and/or inspections on approved forms.Key...


  • Orange, California, United States CHOC - Children's Health Orange County Full time

    Job SummaryThe RN Care Manager is responsible for delivering care coordination services to patients admitted to the inpatient bed. This role involves overseeing the inpatient care team, including the case manager assistant and other members who assist patients and families in navigating the pediatric system of care. The RN Care Manager reviews the formulated...


  • Orange, California, United States Polaris Healthcare Full time

    We are seeking a highly skilled and dedicated Registered Nurse to join our team at Polaris Healthcare. This is a full-time position available in Orange and Rockland Counties.Job DescriptionAs a Registered Nurse, you will be responsible for providing excellent patient care and services, including:Providing physician orders and comprehensive...

  • Account Coordinator

    4 weeks ago


    Orange, California, United States Identified Talent Solutions Full time

    Account Coordinator Job DescriptionIdentified Talent Solutions is seeking a highly motivated and detail-oriented Account Coordinator to support our account management team in the execution of advertising campaigns. As an Account Coordinator, you will play a pivotal role in ensuring the seamless delivery of our services to clients.Key Responsibilities:Client...


  • Orange, California, United States Alta Hospitals Full time

    Job Summary: We are seeking an Inpatient Care Coordinator II to support our inpatient case managers in creating a seamless transition for hospitalized patients and facilitating customer satisfaction.Key Responsibilities:Review daily hospital census and enter new admissions into Essette, notifying inpatient case managers prior to 9:50am.Enter referral...

  • Safety Coordinator

    4 weeks ago


    Orange, California, United States Infojini Full time

    Job DescriptionInfojini is seeking a highly skilled Safety Coordinator to support the Environmental Health & Safety (EH&S) and Facilities departments with day-to-day operations. The ideal candidate will have a strong background in facilities management and be able to coordinate and administer various aspects of the telework and emergency preparedness...


  • Orange, California, United States College of Charleston Full time

    Job Title: Chief Quality Officer, VPJob Summary:We are seeking a highly experienced and skilled Chief Quality Officer, VP to lead our quality and safety initiatives. The successful candidate will have a strong background in healthcare quality and safety, with a proven track record of improving patient outcomes and reducing medical errors.Key...


  • Orange, California, United States Alta Hospitals Full time

    Job SummaryThe Outpatient Care Coordinator II will play a crucial role in identifying and reducing barriers to members' care, ensuring timely access to resources and education on the importance of prompt care. As the primary point of contact, this individual will be an integral part of the members' interdisciplinary care team, providing support and working...


  • Orange, California, United States University Of California Irvine Full time

    Job SummaryThe University of California, Irvine seeks a highly skilled Research Data Coordinator to join our team. As a key member of our clinical research team, you will be responsible for providing comprehensive data management for a research portfolio of Phase I-IV cancer-related protocols.Key ResponsibilitiesCollect and coordinate data submission to...


  • Orange, California, United States University Of California Irvine Full time

    About the RoleThe University of California, Irvine is seeking a highly skilled Research Data Coordinator to join our team. As a key member of our clinical research team, you will play a critical role in supporting the clinical research efforts of the Chao Family Comprehensive Cancer Center.Key ResponsibilitiesProvide comprehensive data management for a...


  • Orange, California, United States Orange County Neuropsychiatric Rese Full time

    Clinical Research Coordinator Job DescriptionWe are seeking a highly skilled and experienced Clinical Research Coordinator to join our team at Orange County Neuropsychiatric Research Institute. The successful candidate will be responsible for coordinating and administering clinical trials under the direction of the Principal Investigator and Scientific...


  • Orange, California, United States vTech Solution Full time

    Oncology Nursing OpportunityWe are seeking a skilled Oncology RN to join our team at vTech Solution. This role requires experience in oncology care, with a focus on providing high-quality patient care and support.Key Responsibilities:• Provide direct patient care in an oncology setting• Collaborate with healthcare teams to develop and implement patient...


  • Orange, California, United States Prospect Medical Holdings Full time

    About the Role:As a Sr. Credentialing Coordinator at Prospect Medical Holdings, you will play a vital role in ensuring the seamless credentialing and re-credentialing of practitioners and organizational providers.Key Responsibilities:• Conduct thorough reviews and analysis of credentialing documents to guarantee accuracy and completeness.• Determine the...


  • Orange, California, United States University of California Full time

    Job Summary:As a Clinical Care Coordinator at the University of California, Irvine, you will play a vital role in ensuring the highest quality patient care. Your primary responsibility will be to assess and reassess patients' needs, setting priorities and implementing care plans that promote self-care outcomes.Collaborating with an interdisciplinary team,...


  • Orange, California, United States Pacific Neuropsychiatric Specialists Inc Full time

    Job DescriptionWe are seeking a highly motivated and detail-oriented Clinical Research Coordinator to join our team at Pacific Neuropsychiatric Specialists Inc. In this role, you will be responsible for developing and implementing recruitment strategies to identify and enroll participants for clinical trials.Key Responsibilities:Develop and implement patient...