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2 days ago
This position plays a critical role in ensuring the highest quality of care for Banner University Health Plan members. As a Quality of Care Coordinator, you will investigate and resolve quality of care concerns, working closely with providers and other stakeholders to identify and address potential issues.
Key Responsibilities- Investigate and resolve quality of care concerns, including medical record review and provider communication
- Prepare and present quality of care cases to the Medical Director for review
- Develop and implement quality of care training programs for Banner University Health Plan staff
- Communicate results of quality monitoring and evaluation to QOC Medical Director, QM Director, and QOC Supervisor
- Identify potential risk management and compliance issues during quality review
To be successful in this role, you will need:
- Two years of clinical experience in an acute care or outpatient setting
- At least one year of experience working in a quality management role in an outpatient or inpatient setting
- A current, valid RN license in the state of practice
- Knowledge of National Medicare and State AHCCCS regulations
- Excellent written and verbal communication skills, strong analytical and problem-solving skills, and ability to work independently
A CPHQ certification is preferred, as is additional related education and/or experience.
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