Clinical Quality & PCMH Improvement Specialist

First Choice Primary Care, Inc.; Macon (GA); On-site; USD 52,000 - 66,000; Full time

Job summary

First Choice Primary Care, Inc. seeks a Clinical Quality Technician to support quality initiatives across the organization, collecting, monitoring and reporting data.

You will work with the Director of Quality and clinical teams to drive compliance and continuous improvement. This on-site role in Macon, GA, runs 8am–5pm and may require travel to other locations; CMA certification and experience with PCMH/NCQA/HEDIS/UDS and EHR systems like eCW are valued.

Qualifications

• High school diploma or equivalent required; associate degree or higher preferred.
• Healthcare knowledge and prior experience in clinical environment preferred.
• Experience with PCMH, NCQA, HEDIS, UDS or similar quality programs.

Responsibilities

• Assists Director of Quality to foster compliance with standards and regulations in QA, UDS data analysis, and PCMH benchmarks.
• Identifies barriers to implementing PCMH model and works with staff to develop solutions to address barriers.
• Performs point of care blood glucose testing and documents results in patient’s electronic medical record.
• Collects blood specimens for HbA1c testing to support diabetes management and quality initiatives
• Conducts HEDIS chart audits and validates documentation for accuracy and completeness.
• Reviews ICD-10 and CPT coding to support risk adjustment and quality reporting efforts.
• Participates in interdisciplinary meetings with population health, utilization management, and provider engagement teams.
• Conducts patient outreach to close preventive and chronic care gaps for Medicare and Medicaid populations.
• Educates patients on preventive screenings and chronic disease management recommendations.
• Utilizes payer portals for care gap closure and suspect condition validation.
• Assists with reporting, monitoring, and tracking performance metrics across multiple quality programs.
• Other duties as assigned by Executive Leadership or the Director of Quality.

Skills

Attention to detail

Time management

Communication skills

Data collection & reporting

Team collaboration

Education

High school diploma or equivalent

Associate degree or higher in a related field preferred

Tools

eClinicalWorks (eCW)

Microsoft Excel

Job description

First Choice Primary Care, Inc. seeks a Clinical Quality Technician to support quality initiatives across the organization, collecting, monitoring and reporting data.

You will work with the Director of Quality and clinical teams to drive compliance and continuous improvement. This on-site role in Macon, GA, runs 8am–5pm and may require travel to other locations; CMA certification and experience with PCMH/NCQA/HEDIS/UDS and EHR systems like eCW are valued.