Quality Management Coordinator (Healthcare Experience)

Job Number: 3379

Workplace Type: Hybrid Remote

Position Title: Quality Management Coordinator

External Description:

The Quality Management Coordinator provides support and project coordination for the quality management program and initiatives. The QM Coordinator supports the QM team and reports directly to the Director of Quality Management.

General Duties/Responsibilities:

(May include but are not limited to)

• Provide administrative support for the quality management department
• Supports Member or Provider outreach initiatives
• Maintains department files in an organized, accurate, secure manner
• Assists with preparation for meetings by typing agenda, preparing slides, attachments and minutes
• Aggregation of data on assigned projects and basic analysis of results
• Maintain up-to-date databases and tracking logs; assist with data collection to support QI projects and initiatives
• Obtains medical records from medical groups, physicians or facilities in support of quality review activities and conduct phone and fax follow-up, to troubleshoot, investigate, and follow up on retrieval of missing medical record information.
• IPA/Medical Group outreach on to gather clinical data on assigned QI projects and initiatives
• Completes special projects or assignments as needed to meet initiatives and/or objectives of department
• Other duties as assigned to ensure compliance of projects and meeting target dates

Supervisory Responsibilities:

This job has no supervisory responsibilities.

 

Minimum Requirements:

 

1. Minimum Experience:
   1. Minimum of two years of experience in a medical office, Health Plan or hospital environment performing administrative duties with a clinical focus
   2. Managed Care Experience
   3. Minimum of two years profession experience with MS Office Suite- Word, Outlook, Excel, Access
   4. Experience with medical terminology
2. Education/Licensure:
   1. Requires a High School Diploma or equivalent
   2. Associates Degree preferred
3. Other:

1. Excellent organizational skills with the ability to manage multiple priorities.
2. Ability to work in a fast-paced environment with changing priorities

1. Work independently and as a part of an integrated team.
2. Ability to take initiative and see tasks to completion.
3. Advanced Computer skills and experience with Microsoft Office Products.
4. Excellent verbal and written communication skills
5. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
6. Problem solving skill sets and analytical ability
7. Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
8. Knowledge of Medicare, Managed Care and HEDIS preferred

Essential Physical Functions:

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 accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. While performing the duties of this job, the employee is regularly required to talk or hear.
2. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
3. The employee frequently lifts and/or moves up to 10 pounds.
4. Specific vision abilities required by this job include close vision and the ability to adjust focus.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Quality Management Coordinator (Healthcare Experience)

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].