Position Title: Quality Specialist
Status: Full Time/Hourly
Department: Quality Improvement/Quality Assurance
Position Reports to: Quality Improvement/ Quality Assurance Director

Summary: Clinica Romero seeks a Quality Specialist to link patients to clinic and preventive health services to support overall wellness and ensure continuous improvement in healthcare delivery. With a focus on culturally and linguistically sensitive approaches, the incumbent will
work towards improving quality performance measures for our diverse patient population. Seamlessly integrating the roles of a Patient Navigator and the ability to transition into the QI Coordinator role as needed, this position is uniquely positioned to drive effective patient care
and operational excellence.

Duties and Responsibilities:

• • Act as a vital liaison connecting patients with various healthcare providers.
  • Conduct outreach via phone to CMOAR patients eligible for preventive services.
  • Identify and address patient barriers to care, such as transportation, insurance, and
    language, by referring them to appropriate resources.
  • Schedule appointments for follow up appointments, consults and support services
    within established service standards, including dietitians, physician, specialty
    departments, etc.
  • Assist in helping patients arrive at scheduled appointments on time and coordinate
    transportation when needed.
  • Prepare patient summaries for the care team's reference, documenting
    recommendations using standardized care protocols aligned with CMOAR guidelines.
  • Compare health plan data with internal HEDIS data to ensure there are no data gaps
  • Review EHR chart documentation and submit supplemental data into COZEVA when
    applicable
  • Assists with the preparation and coordination of HEDIS medical record review
  • Assist QI Coordinator in training of new staff
    Assist with projects aimed at improving patient healthcare outcomes and enhancing performance improvement metrics.
  • Assist with the increase of performance improvement measures by assisting with QI projects.
  • Follow patients throughout the care continuum and collaborate with inpatient care
    management resources
  • Deliver Weekly, Monthly & Quarterly reports that demonstrate outcomes and
    performance improvement activities.
  • Adhere to established productivity benchmarks.
  • Attend trainings and learning opportunities that expand content knowledge and best practices
  • Responsible for outreach efforts to establish and maintain positive working relationships with key departments (physicians, office staff, diagnostic staff, nurses, community organizing, etc.)
  • Gather comments/information from patients and document appropriately in EMR system
  • Provide detailed updates or anecdotes regarding the program

Qualifications/Requirements:

Education:

• • • High school diploma or GED is required. • Medical Assistant certification or pre-med background is required
    • Trained in EPIC or similar electronic health record platforms. • Proficiency in Microsoft Office, especially Excel.
    • 1-2 years of experience working with FQHCs/community health centers. • Familiarity with HEDIS measures and UDS.

Technical Skills:

• • • Trained in EPIC or similar electronic health record platforms.
    • Proficiency in Microsoft Office, especially Excel.

Soft Skills:

• • • Strong problem-solving, decision-making, and critical thinking abilities
    • Exceptional organizational, written, and verbal communication skills.
    • Outstanding interpersonal skills, including the ability to maintain strong relationships with the healthcare team, other departments, and external stakeholders.
    • Demonstrated ability to maintain strict confidentiality.

Language:

• • Bilingual proficiency in English and Spanish.