Quality Coordinator

Advocate Health; Milwaukee (WI); On-site; USD 45,000 - 70,000; Full time

Job summary

An established industry player is seeking a Quality Coordinator to enhance their internal audit and quality improvement efforts. In this pivotal role, you will oversee auditing processes, maintain quality assessment information, and collaborate with management to drive performance improvements. Your expertise in credentialing within a healthcare environment will be crucial as you manage data entry, generate reports, and ensure compliance with quality standards. Join a dynamic team where your contributions will directly impact the quality of care provided to patients. This is an exciting opportunity for someone passionate about quality assurance and healthcare excellence.

Qualifications

• 5-6 years experience in credentialing within acute care or managed care.
• CPCS certification or eligibility to sit for the exam.

Responsibilities

• Oversees internal audit and quality improvement activities.
• Maintains quality assessment information and tracks improvements.
• Coordinates special data entry/change projects.

Skills

PC Skills

Access

Excel

Word

PowerPoint

Verbal communication skills

Organizational skills

Team player

Education

Associate Degree in business or health-related field

Tools

Microsoft Office Suite

Scanning equipment

Job description

Join to apply for the Quality Coordinator role at Advocate Health.

Major Responsibilities:

1. Oversees internal audit and continuous quality improvement activities, policies, and procedures.
2. Contributes to the development of auditing and quality standards for timeliness, accuracy, and method and source.
3. Maintains and tracks quality assessment information in collaboration with Manager and Supervisor, with recommendations for improvements. These include monthly dashboards, analysis, and corrective action plans, if needed.
4. Oversees reports and monitors turnaround times for analysis and action in collaboration with Manager and Supervisor.
5. Initiates audit and error reports for internal quality committee analysis, recommendations, and actions. Requests new reports from Data Analysts and tracks as appropriate.
6. Serves on the internal quality committee with Director, Manager, and Supervisor.
7. Collaborates with Manager and Supervisor on report generation by Data Analysts and assists in analysis for performance improvement.
8. Creates and maintains customer concern reports and acts on them as per policies and quality committee recommendations.
9. Creates and maintains minutes of internal quality committee, Credentials Committee, and Staff Meeting minutes.
10. Performs ongoing monitoring of Medicare and Medicaid sanctions, reporting results to Compliance and internal credentialing customers.
11. Audits initial applications of credentialing coordinators against standards.
12. Responsible for contract maintenance and verifications from outside sources, including fee-based verification processes and maintaining contracts.
13. Creates quarterly bills for internal customers and tracks payments.
14. Manages data entry and oversees data convention adherence, runs audit reports, and manages practitioner data and ongoing monitoring of sanctions.
15. Coordinates special data entry/change projects and provides administrative support for departmental activities.

Education/Experience Required:

• Associate Degree or equivalent in business or health-related field.
• 5-6 years experience in credentialing within an acute care or managed care environment.

Knowledge, Skills & Abilities:

• PC Skills (word processing, data entry, email, etc.)
• Access, Excel, Word, PowerPoint skills preferred.
• Experience with scanning equipment, FAX, copier, etc.
• CPCS certified or eligible to sit for exam.

Physical Requirements and Working Conditions:

• Local travel
• Experience working with physicians
• Ability to sit for extended periods
• Excellent attendance and punctuality
• Verbal communication skills
• Proficiency in computer use and data entry
• Organizational and professional workload management skills
• Assertiveness and political intuitiveness
• Team player and self-motivated
• High-stress and demanding environment

This description provides the general scope of the role; other duties may be assigned as needed.