Quality Improvement Coordinator (Bilingual- Spanish) at ClareMedica Health Partners LLC – Miami Lakes, Florida

Position Title: Quality Improvement Coordinator (Bilingual- Spanish)

Location: Miami Lakes, FL 33016

Description:

*Candidate MUST be based in South Florida and be bilingual (Spanish). This role requires occasional travel to our office locations.
At Claremedica, exceptional is the standard.
Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.

That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At Claremedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.
Opportunity awaits – welcome to Claremedica.

ESSENTIAL FUNCTIONS
The Quality Improvement Coordinator performs evaluation of patient’s satisfaction, review of medical records and Health Plans Information to work on continuous Quality Improvement. The Quality Improvement (QI) Coordinator is responsible for the improvement of patient’s satisfaction with the organization services as well as the improvement of Quality of clinical care. His/Her tasks include the review and abstraction of data and information from Medical Records. The QI coordinator must review among others CPT code and category II codes for performance measurement facilitating data collection about Quality of Care rendered. Present quality performance information on gaps in care to providers and clinic administrators to improve quality outcomes such as HEDIS and other internal quality benchmarks. Work with patients to ensure their engagement and compliance with recommended tests or procedures.

DUTIES AND RESPONSIBILITIES

Coordinating and completing HEDIS Quality Improvement specific projects ensuring consistency with the company strategy, commitment, and goals.

Contacting patients to evaluate their satisfaction with the organization’s services.

Promoting and coordinating actions with other staff from Claremedica centers oriented to identify opportunities for improvement in patient’s satisfaction.

Reviewing Medical Records to collect HEDIS information if needed.

Appropriate use of organization EMR and/or HEDIS software (data entry, reporting)

Proactively identify opportunities for improvement, looking for existing issues or new problematic areas, trends, etc.

Prepares Quality/ HEDIS reports in an accurate, concise, and timely fashion.

Perform other related duties oriented to reach the organization’s Quality/HEDIS monthly and yearly goals.

Contact and educate patients to ensure better compliance with recommended behaviors

Proactively work and collaborate with clinical and administrative staff at the center.

QUALIFICATIONS/REQUIREMENTS

High school diploma or GED required

Minimum of 1 year of HEDIS/Quality experience in primary care organization and or specialist office, managed care organization preferred

Proficient in official coding guidelines, ICD-10CM, CPT-4 and HCPCS.

Working knowledge of Stars/HEDIS measures, CPT codes to bill activities and interventions needed to close gaps in care for HEDIS and Stars.

Collection and review of Medical Record when needed.

Proficient knowledge of computers and typical production software (e.g., MS Office, Outlook, Word, Excel, PowerPoint, etc.).

Effective communication skills

Experience and proficiency with different Electronic Medical Records

Position may require traveling throughout Florida, including and not limited to driving between site locations throughout Miami-Dade and Broward County locations.

WORKING CONDITIONS
General office working conditions.

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

While performing the duties of this job, the employee will be required to stand, walk, sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust your focus. Manual dexterity is required to use desktop computers and peripherals.

WORK ENVIRONMENT
The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

TRAVEL
Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.
SAFETY HAZARD OF THE JOB
Minimal Hazards


This job description does not list all the duties and responsibilities of the job. You may be asked by supervisors or managers to perform other instructions, duties, and responsibilities, as appropriate. You will be evaluated in part based upon your performance of the duties and responsibilities identified in this job description.

Management has the right to revise this job description at any time. The job description is not a contract for employment, and either you or the employer may terminate employment at any time, with or without cause, with or without notice.