Quality Management Coordinator (Healthcare & Project Coordination Exp)

Alignment Healthcare

Orange County, CA, US
  • Job Type: Full-Time
  • Function: Life Sciences QA/QC
  • Post Date: 01/10/2021
  • Website: alignmenthealthcare.com
  • Company Address: 4 Park Plaza Suite 500, Orange, CA, 92614

About Alignment Healthcare

Alignment Healthcare is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. With offices and care centers across the country, Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers HMO plan options to California residents through the Alignment Health Plan, and partners with select health plans in North Carolina and Florida to help deliver better benefits at lower costs.

Job Description

The Quality Management Coordinator provides support and project coordination for the quality management program and initiatives. The QM Coordinator supports the QM team and reports directly to the Director of Quality.

 

General Duties/Responsibilities:

(May include but are not limited to)

  • Provide administrative support for the quality management department
  • Maintains all department files in an organized, accurate, secure manner
  • Assists with preparation for meetings by typing agenda, preparing slides, attachments and minutes
  • Mailing, collection and aggregating survey data
  • Maintain up-to-date databases and tracking logs; assist with data collection to support QI projects and initiatives
  • Support Member or provider outreach initiatives
  • Obtains medical records from medical groups, physicians or facilities in support of quality review activities and conduct phone and fax follow-up, to troubleshoot, investigate, and follow up on retrieval of missing medical record information.
  • Completes special projects or assignments as needed to meet initiatives and/or objectives of department
  • Other duties as assigned to ensure compliance of projects and meeting target dates

Supervisory Responsibilities:

This job has no supervisory responsibilities.

 

Minimum Requirements:

 

  1. Minimum Experience:
    1. Minimum of two years of experience in a medical office, Health Plan or hospital environment performing administrative duties with a clinical focus
    2. Managed Care Experience
    3. Minimum of two years profession experience with MS Office Suite- Word, Outlook, Excel, Access
    4. Experience with medical terminology
  2. Education/Licensure:
    1. Requires a High School Diploma or equivalent
    2. Associates Degree preferred
  3. Other:
    1. Excellent organizational skills with the ability to manage multiple priorities.
    2. Ability to work in a fast-paced environment with changing priorities
  1. Work independently and as a part of an integrated team.
  2. Ability to take initiative and see tasks to completion.
  3. Advanced Computer skills and experience with Microsoft Office Products.
  4. Excellent verbal and written communication skills
  5. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
  6. Problem solving skill sets and analytical ability
  7. Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
  8. Knowledge of Medicare, Managed Care and HEDIS preferred


Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  1. While performing the duties of this job, the employee is regularly required to talk or hear.
  2. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
  3. The employee frequently lifts and/or moves up to 10 pounds.
  4. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Related Jobs

Advanced Practice Clinician, CAW

Alignment Healthcare - Modesto, CA, US

Advanced Practice Clinician, CAW

Alignment Healthcare - Stockton, CA, US

Advanced Practice Clinician, CAW

Alignment Healthcare - Los Angeles, CA, US

Advanced Practice Clinician, CAW Temp

Alignment Healthcare - Riverside, CA, US

Appeals & Grievance Coordinator (Temporary)

Alignment Healthcare - Orange County, CA, US
Disclaimer: Local Candidates Only
This company does NOT accept candidates from outside recruiting firms. Agency contacts are not welcome.