Quality Improvement Assistant in North Charleston, South Carolina at FETTER HEALTH CARE NETWORK INC

The Quality Improvement/Assurance Assistant at Fetter Health Care Network (FHCN) carries out diverse responsibilities under the guidance of the program manager. These duties are aimed at supporting quality improvement, population health, and clinical activities to enhance patient outcomes and care delivery. The assistant actively participates in the continuous quality improvement process and maintains a thorough understanding of departmental standard operating procedures. This includes familiarity with specialized measures, platforms, and procedures, as well as quality control requirements and preventive maintenance.

ESSENTIAL DUTIES AND RESPONSIBILITIES (Included but not limited to the following):

• Contact patients and schedule appointments for providers, ancillary staff, and resources.
• Manage internal referrals (e.g. dietitian, diabetic educator, pharmacist, behavioral health, case managers, etc), including scheduling, follow-up, and closing the referrals.
• Annual Wellness Visits (AWVs) – Call and complete health risk assessment questionnaire as part of scheduling an AWV.
• Ability to navigate 3rd party platforms (e.g. Waystar) to determine AWV eligibility.
• Validate and perform quality review of scanned records as well as monitor and maintain the integrity of the legal medical record.
• Review and label medical documentation appropriately in the EMR system.
• Follow-up with patients for transitional care management (e.g. after hospital discharge or ER visit).
• Review open quality care gaps and address them as necessary.
• Work across multiple departments within the agency to support quality improvement initiatives.
• Attend quality improvement committee as well as payor meetings and manage the meeting notes and action plans as needed.
• Identify trends in scanning errors and processes and communicate to management.
• Relocate electronic images that are incorrectly filed in another document or encounter.
• Assist with quality review of medical records as appropriate and determined by manager.
• Roster management of healthcare plans, contacting patients to schedule appointments to close gaps in care.
• Will make at least three (3) attempts to contact patient in the attempts of encouraging completing necessary tests and screenings to close care gaps.
• Interaction with patients is documented in Electronic Medical Record (EMR) system.
• Review patient chart in EMR for any tests or screenings completed within the quality measure guidelines.
• Conduct search in other systems (e.g. Labcorp database, Azara, etc) and hospital EMR to locate any record(s) that demonstrate completion of screening or testing.
• Review patient's previous history and referrals that may indicate that tests or screenings have been completed by provider outside of network.
• Obtain a medical release from patient to retrieve the necessary records from provider(s) outside of network.
• Completes required continuous training and education, including department specific requirements.
• All other duties as assigned.

EDUCATION AND EXPERIENCE:

• High school graduate or equivalent.
• Minimum one (1) year previous medical back-office experience, preferably within an outpatient organization.
• Electronic Medical Records (EMR) experience preferred.
• Excellent communication skills; customer focused; excellent attention to detail; able to prioritize tasks and meet deadlines; strong interpersonal skills; able to work in a team environment.
• Proven ability to interface with all personnel and patients (physicians/providers, organizational staff, insurance companies, patients and family members).
• Basic knowledge of medical terminology.
• BLS certification.