Quality Assurance Coordinator

Healthyuclinics; Hyde Park Township (IL); On-site; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Clinical Quality Coordinator to enhance clinical quality and regulatory compliance. This role is crucial in driving quality improvement initiatives, coordinating audits, and collaborating with clinical teams to optimize patient care. You'll be instrumental in managing quality data submissions and educating staff on best practices. If you're passionate about healthcare quality and thrive in a dynamic environment, this opportunity offers a chance to make a significant impact on patient outcomes and organizational success.

Qualifications

• 3+ years of experience in healthcare quality improvement.
• Strong knowledge of HEDIS, Stars, CMS, and NCQA.

Responsibilities

• Support quality improvement initiatives for VBC program targets.
• Manage submissions of quality data to payers and regulatory bodies.

Skills

Healthcare Quality Improvement

Data Analytics

Communication Skills

Problem-Solving Skills

Population Health Management

Education

Certification in Medical Assisting

Healthcare Administration

Public Health

Tools

EMRs

Data Analytics Tools

Job description

Description

The Clinical Quality Coordinator plays a pivotal role in ensuring the organization meets clinical quality goals, regulatory requirements, and performance metrics tied to value-based care contracts. This role supports the implementation and monitoring of quality improvement initiatives and serves as a liaison between clinical teams, health plans, and data analysts.

Key Responsibilities:

• Support quality improvement initiatives aimed at achieving VBC program targets (e.g., HEDIS, Stars, ACO, CMS measures).
• Coordinate chart reviews, clinical documentation audits, and data validation processes.
• Partner with providers and care teams to improve performance on preventative care, chronic disease management, and care gap closure.
• Assist in delivery of provider and staff education on clinical quality standards and documentation best practices.
• Manage submissions of quality data to payers and regulatory bodies in accordance with contract and compliance timelines.
• Maintain knowledge of evolving value-based care models, clinical quality metrics, and regulatory requirements.
• Serve as a subject matter expert and resource for clinical teams on quality improvement strategies and evidence-based practices.
• Support patient engagement efforts tied to quality goals, such as outreach for screenings, immunizations, and wellness visits.
• Performs all other duties as assigned.

Requirements

• Certification in Medical Assisting, Healthcare Administration, Public Health, or related field.
• 3+ years of experience in healthcare quality improvement, preferably in a value-based care or managed care environment.
• Strong knowledge of HEDIS, Stars, CMS, NCQA, and other quality performance programs.
• Experience working with EMRs, data analytics tools, and clinical workflows.
• Excellent communication, organization, and problem-solving skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Experience with population health management tools and care coordination programs.
• Familiarity with ACO, PCMH, MSSP, or Medicare Advantage quality programs.