UNLV Health
Quality Coordinator
UNLV Health, Las Vegas, Nevada, us, 89105
The Quality Coordinator is responsible for ensuring that the collection of Healthcare Effectiveness Data and Information Set (HEDIS), and Quality programs are accurate, efficient, timely, and within compliance guidelines. While ensuring FOS or MA roles are met.
ADVANTAGES OF WORKING FOR UNLV HEALTH
Clinic Hours are Monday through Friday, 8AM to 5PM! (Actual hours may vary depending on business need)12 Paid Holidays per year, starting with your first day of employment!20 + PTO days per year! (Depending on Position)3% 401K Contribution, even if you do not contribute!Medical, Dental, and Vision benefits that start the first of the month following your start date!Pay may be higher than stated range, based on experience.And more!MAJOR RESPONSIBILITIES
Ensures processes for obtaining quality data in support of each payer contract/agreement with duties including but not limited to:
HEDIS/Quality
Research any discrepancies found by reviewing medical records and any other relevant informationIdentify trends and document any errors foundApplying structured auditing criteria to medical records to determine compliance with HEDIS and Quality standardsDemonstrate expertise in the requirements and parameters of mandated HEDIS and Quality performance measuresProvide participation program requirements within electronic health records and report to departments and leadership.Coordinate, Monitor, and report progress toward completion of the annual HEDIS/Quality chart abstraction processUnderstand and have access to payer insurance portalsCoordinate HEDIS/Quality processes and establish a plan to improve scoresImplement a process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunitiesPerforms other duties as assigned
Quality Control Audits:
Works with the Executive Director, Payers, and the departments to report/monitor HEDIS/Quality program requirements and progress monthly.Reviews daily, weekly, and monthly key metrics to identify trends or areas of focus; works with the Executive Director of Clinical Operations to develop, document, and implement action plans, as appropriate, to address issues
Training:
Identifies opportunities for HEDIS/Quality/revenue improvement, automation, or issue resolution.Creates and provides data to baseline and drive solution outcomesAssimilates new staff into the department and provides ongoing training for the existing team
Coordinate Workflow:
Provides Executive Director of Clinical Operations and company leadership with information regarding HEDIS/Quality/Accounts Receivable and/or departmental performanceDevelops and presents information to leadershipImplements improvements in the work process that both improve the efficiency and effectiveness of the physician clinics
Service Excellence:
Treats patients, staff, and others with dignity, respect, and fairnessDelivers exceptional customer service during all interactionsServes with compassion and humility, acts with genuine care and concern for othersCommunicates with honesty and transparencyWorks as an effective and cooperative team memberIs receptive to constructive feedbackContributes to a culture of inclusionActs with integrity and ensures that words, deeds, and actions are alignedComply with all departmental and company policy and proceduresCompletes any duties and special assignments as requested
Educational Requirements
High School Diploma or equivalencyGraduation from a Medical Assistant program requiredQualifications
At least three years of healthcare experience requiredMust possess the following above-average skills in, but not limited to, verbal, writing/composing, correspondence/reports, analytical and designMedical Terminology, anatomy, and physiologyMicrosoft Office knowledgeMust be well organized and detail-orientedPhysical requirements
May include standing, sitting, and/or walking for extended periodsMay include performing repetitive tasksMay include working with challenging patients and clientsMay include lifting up to 25 pounds
UNLV Health will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.
If you have any questions about our interview and hiring procedures, please contact Recruitment at healthjobs@medicine.unlv.edu
ADVANTAGES OF WORKING FOR UNLV HEALTH
Clinic Hours are Monday through Friday, 8AM to 5PM! (Actual hours may vary depending on business need)12 Paid Holidays per year, starting with your first day of employment!20 + PTO days per year! (Depending on Position)3% 401K Contribution, even if you do not contribute!Medical, Dental, and Vision benefits that start the first of the month following your start date!Pay may be higher than stated range, based on experience.And more!MAJOR RESPONSIBILITIES
Ensures processes for obtaining quality data in support of each payer contract/agreement with duties including but not limited to:
HEDIS/Quality
Research any discrepancies found by reviewing medical records and any other relevant informationIdentify trends and document any errors foundApplying structured auditing criteria to medical records to determine compliance with HEDIS and Quality standardsDemonstrate expertise in the requirements and parameters of mandated HEDIS and Quality performance measuresProvide participation program requirements within electronic health records and report to departments and leadership.Coordinate, Monitor, and report progress toward completion of the annual HEDIS/Quality chart abstraction processUnderstand and have access to payer insurance portalsCoordinate HEDIS/Quality processes and establish a plan to improve scoresImplement a process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunitiesPerforms other duties as assigned
Quality Control Audits:
Works with the Executive Director, Payers, and the departments to report/monitor HEDIS/Quality program requirements and progress monthly.Reviews daily, weekly, and monthly key metrics to identify trends or areas of focus; works with the Executive Director of Clinical Operations to develop, document, and implement action plans, as appropriate, to address issues
Training:
Identifies opportunities for HEDIS/Quality/revenue improvement, automation, or issue resolution.Creates and provides data to baseline and drive solution outcomesAssimilates new staff into the department and provides ongoing training for the existing team
Coordinate Workflow:
Provides Executive Director of Clinical Operations and company leadership with information regarding HEDIS/Quality/Accounts Receivable and/or departmental performanceDevelops and presents information to leadershipImplements improvements in the work process that both improve the efficiency and effectiveness of the physician clinics
Service Excellence:
Treats patients, staff, and others with dignity, respect, and fairnessDelivers exceptional customer service during all interactionsServes with compassion and humility, acts with genuine care and concern for othersCommunicates with honesty and transparencyWorks as an effective and cooperative team memberIs receptive to constructive feedbackContributes to a culture of inclusionActs with integrity and ensures that words, deeds, and actions are alignedComply with all departmental and company policy and proceduresCompletes any duties and special assignments as requested
Educational Requirements
High School Diploma or equivalencyGraduation from a Medical Assistant program requiredQualifications
At least three years of healthcare experience requiredMust possess the following above-average skills in, but not limited to, verbal, writing/composing, correspondence/reports, analytical and designMedical Terminology, anatomy, and physiologyMicrosoft Office knowledgeMust be well organized and detail-orientedPhysical requirements
May include standing, sitting, and/or walking for extended periodsMay include performing repetitive tasksMay include working with challenging patients and clientsMay include lifting up to 25 pounds
UNLV Health will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.
If you have any questions about our interview and hiring procedures, please contact Recruitment at healthjobs@medicine.unlv.edu