Clinical Quality Project Coordinator

Healthfirst, Inc.; New York (NY); Hybrid; USD 59,000 - 80,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401k contributions

Incentive programs

Job summary

Healthfirst, Inc. is seeking a Clinical Quality Project Coordinator to manage and streamline medical record retrieval processes. The role includes on-site, remote, and field work, ensuring timely requests and accurate documentation across provider offices and facilities.

You will perform quality checks on records, track progress using EMR and provider portals, and communicate status to stakeholders. Travel within the NYC metro area may be required.

Qualifications

• High school diploma or GED required.
• Willingness to travel around NYC metro area and Long Island.
• Experience in health insurance/managed care preferred.

Responsibilities

• Coordinate medical record retrieval from providers, hospitals, and facilities, including on-site as needed.
• Submit, track, and monitor requests with accurate documentation of status.
• Follow up on outstanding requests and escalate barriers when needed.
• Perform quality checks on received records for completeness and accuracy.
• Use EMR, provider portals, and MS Office to track, reconcile, and report activity.
• Provide status updates to management and stakeholders.
• Maintain confidentiality of PHI per Healthfirst policies.
• Meet productivity and turnaround-time expectations.
• Participate in training and project activities.

Skills

Microsoft Excel

Outlook

Travel flexibility

MS Office Suite

Education

HS diploma or GED

Associate’s degree

Tools

EMR systems

Provider portals

Microsoft Office

Job description

The Clinical Quality Project Coordinator is responsible for coordinating medical record retrieval activities, including in-person retrievals at provider offices and healthcare facilities. Responsibilities include submitting and tracking record requests, monitoring and following up on outstanding requests, performing quality checks of received records for completeness and accuracy, and resolving or escalating retrieval barriers. The position maintains accurate documentation of retrieval activities and works with internal teams, provider and vendor contacts to ensure timely completion of medical record requests, supplemental data submissions and project goals. This position has a hybrid work location: Remote, office-based, and in the field as needed. Office location is 100 Church Street, New York.

Duties & Responsibilities:

• Coordinates medical record retrieval activities from provider offices, hospitals, clinics, and other healthcare facilities, including in-person/on-site retrievals as required
• Submits, tracks, and monitors medical record requests through approved retrieval methods and maintain accurate documentation of request status and activity
• Conducts timely follow-up on outstanding requests and work with provider contacts to resolve barriers impacting record retrieval; elevate unresolved issues as appropriate
• Performs quality checks of received medical records to ensure documentation is complete, accurate, legible, and responsive to the request; proactively follow up on incomplete or missing records
• Utilizes internal systems, electronic medical records, provider portals, Microsoft Excel, and other approved tools to track, reconcile, and report retrieval activity
• Provides status updates on retrieval progress, outstanding requests, barriers, and completion rates to management and project stakeholders
• Maintains confidentiality and handle medical records and protected health information in accordance with Healthfirst policies and applicable privacy and security requirements
• Meets established productivity, quality, accuracy, and turnaround-time expectations
• Supports designated team supplemental data training and submission reconciliation activities for providers and vendors as required
• Participates in required meetings, training, and project activities. Performs additional duties as necessary and as directed

Minimum Qualifications:

• HS diploma or GED from an accredited institution
• Ability to travel around the NYC metro area (five boroughs) and Long Island as necessary

Preferred Qualifications:

• Associate’s degree or higher from an accredited institution
• Prior experience in Managed Care/Health Insurance, in a health-related field or environment
• Knowledge of HEDIS/QARR and/or Medicare Stars
• Strong working knowledge of Microsoft Office Suite and Outlook

Compliance & Regulatory Responsibilities: Noted above

License/Certification: N/A

Hiring Range*:

Greater New York City Area (NY, NJ, CT residents): $58,900 - $80,070

All Other Locations (within approved locations): $51,000 - $74,880

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER.HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [e-mail] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights