QUALITY IMPROVEMENT COORDINATOR

Palms Medical Group•High Springs, FL

About The Position

We hire to retire. Come join our amazing team of professionals offering total family wellness and healthcare to residents of 7 counties via our 13 offices in North Florida. Position Summary The Quality Improvement Coordinator is responsible for coordinating quality management efforts for the organization and at the site level, including development, implementation, education, data collection, and analysis.

Requirements

Must be organized, a self-starter and detailed oriented
Job duties require the ability to work independently and as part of a team
Exhibit leadership ability
Skill in effective communication and education
Demonstrate adaptability to changes in the healthcare environment, project management and daily activities.
5 years of healthcare experience, with at least 1 year of healthcare administration.
Degree in nursing
Education may be substituted for experience
Employee will be expected to navigate and operate Microsoft Office suite products, including Word, Excel and PowerPoint.
Knowledge of CQI principles, practices, methods, and tools
Ability to analyze QI data and identify trends and corrective actions
Knowledge of clinical quality measures and the parameters for those quality gaps ah the state and national levels.
Current BLS (basic life support) Certification
Nursing license/certification (healthcare experience may substitute)
Effectively and tactfully communicates complex and/or technical information to co-workers, patients and/or vendors of various educational, socioeconomical and cultural backgrounds.
Establish and maintain effective working relationships at all organization levels, as well as with other agencies and the public.
Standing for long periods of time
Sitting for long periods of time
Viewing a computer monitor for long periods of time
Bending
Stretching / Reaching
Walking short distances
Lifting up to 50 pounds
Operating office equipment (computer, fax machines, telephones and copy machines)
Reading forms / Instructions / Patients Charts
Communicating well to people of various ages, educational levels, cultural backgrounds in person or by telephone
Exposure to potentially violent / irate patients
Exposure to chemical infectious / contagious illness
Exposure to chemical and inhalation of antibiotics during reconstitution
Exposure to X-Ray radiation
Exposure to a variety of scents and odors
Must utilize universal precaution in clinical or exposure situations as prescribed by federal state, and local guidelines and /or laws

Nice To Haves

Medical coding knowledge and experience recommended
AAPC Coding certificate is preferred but not required
Certification in healthcare quality (CPHQ, etc.) preferred but not required

Responsibilities

Works cooperatively with the EVP of Clinical Compliance, CMO, and VP’s of Practice Management to coordinate quality improvement efforts and fulfill organizational quality goals.
Helps EVP of Clinical Compliance to plan, design, implement, and maintain a comprehensive continuous quality improvement (CQI) program including clinical quality, utilization management, and risk management.
Monitors site efforts to ensure compliance with internal and external QI standards. Reviews medical records and other documentation to ensure quality care.
Provides guidance and serves as a resource to site supervisors regarding prioritization of quality projects and evaluates effectiveness of quality improvement interventions.
Meets with site staff to identify and problem solve QI issues.
Analyzes patient records to determine if appropriate coding and clinical care guidelines are utilized to minimize reimbursement denials and comply with CMS and payer quality goals and provide education to providers and other clinical staff as needed based on findings.
Coordinates and performs patient outreach regarding unmet quality measures.
Collects clinical outcomes data and performs analysis in support of clinical process improvement initiatives.
Performs detailed analyses of varied healthcare data to evaluate programs and product solutions using healthcare medical, pharmacy, lab and utilization data.
Provide support and serve as leads for sites in Chronic Care Management and Medicare Annual Wellness Visits.
Creates and evaluates the data needs of assigned projects and assures the integrity of the data.
Probes into technical details and data irregularities and provides detailed analysis of findings.
Develop proficiency and serve as subject matter experts in the “NextGen” EHR and EPM system, population health tools, and payer or other quality portals
Develop reports from the “NextGen” and applicable population health systems to provide needed data to senior management and other users
Assist in compilation of data to fulfill UDS reporting requirements
Compile information and provide support as needed for AAAHC, PCMH, NCQA, FTCA, and other certifications/accreditations for Palms Medical Group
Assist Quality Department (EHR Director, Special Projects Coordinator and Infection Control and Risk Coordinator) with projects and data evaluation as needed to meet demands of department.
Serve as liaison between payers/external partners and the organization to assist in meeting mutual quality goals.
Identify potential grant opportunities related to quality improvement and serve as project leads on efforts related to grant project plan.
Serve as project lead for new quality tools and projects.
Serve on QA/QI committee, prepare QI reports, and present on relevant topics as directed by the committee chair.
Attends required department and organizational meetings.
Provide support and leadership to site staff, particularly quality related clinical functions. This includes nursing logs, quality workflows, vaccines and the Vaccines For Children program, site and organizational quality improvement activities, ER and hospital follow-ups, and appointment agendas.
Provide mentorship and training to nursing staff.
Other duties as assigned by the EVP Clinical Compliance Officer / Risk Manager or the CEO.