Quality Coordinator

InnovaCare Partners, LLC Job Title: Quality Care Coordinator Job Summary: The role of the Quality Coordinator is performing audits on all medical records contained in ours health care facilities. Also known as medical auditors, they review the data to ensure the accuracy of the record as well as assess the quality of patient care. Medical reviewers must complete at least a two-year associate's degree through a technical school or community college. These skills include, but are not limited to, positive relationship building, effective written/verbal communication, and ability to effect change, perform critical clinical analysis, plan and organize effectively reports. It is crucial for the Quality Coordinator to have knowledge of CMS stars rating process, Medicaid Quality measures programs and clinical standards and outcomes. Responsibilities: 1. Daily review next day of assigned provider’s Cap patients. 2. Daily review next day Quality actions found previous day Caps patients. 3. Responsible for coordination of care regarding quality gaps measures pending with our office managers and QI director. 4. Responsible for coordination of any Quality gaps measures events with QI director. 5. Responsible for coordination of Quality Chart review request from insurance companies in the offices. 6. Responsible to coordinate with office managers any medical records from Hospital, specialist visit and/or SNH for office follow up missing in chart. 7. Identified and follow up with billing department medical assistant’s documentation errors regarding quality measures. 8. Send to QI Director Spreadsheet report on time for process. 9. Responsible for keep our EHR system (ECW ) up to date as: • Identified and correct any patient’s information error. • Quality Spreadsheet • CDSS/Alerts • Quality Global Alerts • Arcadia Quality Measures Portal. Skills and Specifications • Comprehensive Chart Review abstraction based on current CMS Star Rating Medicaid Quality programs . • Capable to do clinical correlations to increase quality care of our members . • Critical Thinking / Problem solving/Computer / EHR system (ECW preferred) • Clinical background including disease and case management protocols. • Providers advocacy and empowerment /Conference and meetings • MD Degree (Foreign Physician) • Up to 2 years Stars Rating /Medicaid Quality measures experience The foundation for InnovaCare was laid in 1998 when President and CEO Richard Shinto, M.D., founded North American Medical Management (NAMM) in California. Since then, InnovaCare Health has continuously evolved and innovated to remain at the forefront of healthcare and deliver cutting-edge solutions to our physicians and team members, patients, and their families. Across InnovaCare, we are united by a shared mission, vision, and values. Our growing company strives to make every member of our diverse team feel fulfilled and valued through their work. Our mission is to transform the lives of the people we serve through compassionate, high-quality care, innovative solutions, and trusted partnerships as we vision a new definition of the standard of excellence in healthcare. Today, InnovaCare operates more than 30 clinics and is recognized as a leader in transforming care delivery. Our approach combines physician-led care models with cutting-edge technology and a focus on personalized, coordinated care to empower providers to succeed in some of healthcare's most challenging environments.