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.
Candidates must be legally authorized to work in the United States. Please Note: UNLV Health does not provide employment sponsorships or sponsorship transfers for any positions.
ADVANTAGES OF WORKING FOR UNLV HEALTH
Clinic Hours are Monday through Friday, 8AM to 5PM (Actual hours may vary depending on business need)
12 Full Day and 2 Half Day 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 (after 90 days)
Medical, Dental, and Vision benefits that start the first of the month following your start date
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 information
Identify trends and document any errors found
Applying structured auditing criteria to medical records to determine compliance with HEDIS and Quality standards
Demonstrate expertise in the requirements and parameters of mandated HEDIS and Quality performance measures
Provide 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 process
Understand and have access to payer insurance portals
Coordinate HEDIS/Quality processes and establish a plan to improve scores
Implement a process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
Performs 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 outcomes
Assimilates 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 performance
Develops and presents information to leadership
Implements 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 fairness
Delivers exceptional customer service during all interactions
Serves with compassion and humility, acts with genuine care and concern for others
Communicates with honesty and transparency
Works as an effective and cooperative team member
Is receptive to constructive feedback
Contributes to a culture of inclusion
Acts with integrity and ensures that words, deeds, and actions are aligned
Comply with all departmental and company policy and procedures
Completes any duties and special assignments as requested
Educational Requirements
High School Diploma or equivalency
Graduation from a Medical Assistant program required
Qualifications
At least three years of healthcare experience required
Must possess the following above-average skills in, but not limited to, verbal, writing/composing, correspondence/reports, analytical and design
Medical Terminology, anatomy, and physiology
Microsoft Office knowledge
Must be well organized and detail-oriented
Physical requirements
May include standing, sitting, and/or walking for extended periods
May include performing repetitive tasks
May include working with challenging patients and clients
May 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