Quality Improvement Coordinator/Revenue Integrity Programs

Position Scope:

The Quality Improvement Coordinator - Revenue Integrity Programs is responsible to the Chief Medical Officer during program development and early data gathering/reporting efforts (estimated 1 year) and the Manager of Quality Improvement thereafter. This position functions to gather and measure data, report, and help develop programs that improve quality and service relating to HEDIS and health plan STARS measure. This position will also assist with other Quality Improvement and HCC/MRA coding duties as needed.

Candidates for this position must meet the following:

REQUIREMENTS:

• LPN/RN with current Florida license
• Excellent clinical skills - minimum 5 years clinical experience preferable
• Knowledge and experience in Quality Improvement techniques, HEDIS, NCQA are a plus but not required
• Ability to travel locally in Tampa Bay and occasionally Orlando. Ability to drive to multiple health centers for audits and presentations, review medical charts, extract information, teach, and implement programs
• Willingness to attend national training conference out of area and ability to acquire knowledge base on Quality Improvement standards and techniques relating to HEDIS, STARS, NCQA, etc.
• Ability to prepare reports and graphs, analyze data, and create/implement corrective action plans
• Excellent clinical data extraction and analytical ability a must
• Computer literate preferred-Microsoft Office (Word, Excel) email
• Able to organize, prioritize and handle multiple projects at the same time, and achieve goals on time. Able to work independently and be a self starter. Must be results oriented
• Able to develop and implement action plans for health centers to improve performance
• Willing and able to be flexible and function in diverse roles as business needs dictate
• Able to communicate well (written and spoken), make presentations to physicians and managers and other clinical and non-clinical staff, work with cross functional teams, lead projects, conduct training
• Able to read, write, speak and understand English language fluently

RESPONSIBILITIES:

The Quality Improvement Coordinator - Revenue Integrity Programs is responsible to the Chief Medical Officer during program development and early data gathering/reporting efforts (estimated 1 year) and the Manager of Quality Improvement thereafter. This position functions to gather and measure data, report, and help develop programs that improve quality and service relating to HEDIS and health plan STARS measure. This position will also assist with other Quality Improvement and HCC/MRA coding duties as needed.

• Review medical charts at health centers in Tampa and occasionally Orlando in order to extract both clinical and non-clinical information, and teach/implement programs to improve quality and service
• Acquire data from internal systems and develop reports
• Attend local or national conference to acquire knowledge base for the organization in HEDIS, STARS, NCQA, Quality Improvement, etc.
• Prepare reports and graphs, analyze data, identify trends, and create/implement corrective action plans to improve quality and service
• Communicate findings to managers, physicians, center administrators and others, and work with corporate and health center teams to improve performance toward goals
• Work with health plans to better understand Quality and Service measures and communicate that information internally at JSA
• Other duties as assigned