Quality and Improvement Coordinator

I. Minimum Qualifications

• Minimum of High School Diploma or equivalent
• Ability to work well with others and under pressure
• Strong attention to detail and organizational skills
• Experience in healthcare or a clinical lab setting preferred
• Excellent oral and written communication skills
• Ability to articulate and communicate effectively in person, in e-mail and on the phone
• Ability to multi-task in a fast paced clinical/office environment
• Proficiency with Electronic Medical Records (EMR) and Microsoft Office products
• Ability to work individually

II. Essential Functions of Position

A. Quality and Improvement

1. Accountable for Project management and organization of assigned specific projects by the Quality and Improvement Manager
2. Assist with Referral management and HIE related activities
3. Close HEDIS gaps through carrier appropriate means for all carriers as directed by Quality and Improvement committee
4. Assist with HEDIS related records requests
5. Assist offices with reports/information on HEDIS gaps that need patient intervention.
6. Assist with PCMH and PCSP program implementations, renewals and process workflows
7. Assist with MIPS programs implementations, reporting, workflows and attestations
8. Accountable for managing electronic communications with In Patient facilities regarding ER visits and discharges and appropriate follow up with patients/physicians

B. Clerical Duties

1. Accountable for processing accurate monthly capitation lists for Capital Health Plan and periodic member lists for other insurance carriers and performing any manual adjustments as needed and providing the reconciled reports to the offices within the group.
2. Accountable for diagnosis code and other chart data entry as directed by PO Committee
3. Assist with patient chart audit activities
4. Other clerical duties as directed

   Follow My Health Liaison and support

C. External Communication

1. Assist with new employee training and continual support
2. Communicate with all insurance companies to comply with HEDIS data collection processes
3. Coordinate with outside medical facilities to arrange notification of discharges to home and other facilities
4. Communicate with key staff at NCQA, Florida Blue and AHIT as necessary to validate appropriate determinants are in place for appropriately reporting PCMH and/or HEDIS data

D. Safety

1. Wear TPCA badge during work hours
2. Report any safety and/or OSHA violations witnessed to the Director of Human Resources
3. Comply with OSHA standards

E. Cooperation

1. Coordinate duties with other staff members
2. Communicate professionally and effectively with co-workers within and outside of TPCA

F. Judgement

1. Comply with HIPAA and all TPCA policies
2. Report any violations witnessed while working to the appropriate personnel

G. Reliability

1. Complete assigned tasks in a timely fashion
2. Punctual and efficient
3. Other duties as assigned

H. Perform other related duties incidental to the work described herein

III. Physical Requirements of Position

A. Must be able to effectively communicate with co-workers and supervisor

B. Occasional bending, stooping, lifting and stretching

C. Ability to sit at a desk and operate computer equipment for extended periods of time

Tallahassee Primary Care Associates is an EOE/ADAAA and Drug Free Workplace.

This employer participates in E-Verify.