Quality Management Coordinator

Dignity Health; Bakersfield (CA); Remote; Full time

Job summary

A leading healthcare organization is seeking a Quality Management Coordinator to enhance clinical quality across the enterprise. This remote role involves data management, collaboration with departments, and handling member appeals. The position requires administrative experience and knowledge of coding procedures. Join a team dedicated to improving healthcare delivery and services.

Benefits

Medical, dental, and vision plans

401(k) plan with employer match

Paid time off

Long-term disability

Qualifications

• At least 2 years of experience in an administrative position.
• Knowledge of CPT, ICD-10, and HCPCS coding procedures.

Responsibilities

• Assist in promoting QM activities related to healthcare delivery.
• Coordinate, process, and resolve incoming member appeals.

Skills

Collaboration

Problem Solving

Education

Associates degree

Tools

Excel

Access

Job description

Responsibilities

• This position is remote.

Position Summary

The Quality Management Coordinator will be part of the Quality Management department, which focuses on measuring and improving clinical quality functions across the enterprise. Under the supervision of the Manager of Quality Administration, the coordinator will assist in promoting QM activities related to monitoring, assessing, and improving healthcare delivery and services to plan members. Responsibilities include data collection, data entry, record maintenance, chart audits, member mailings, committee facilitation, collaboration with other departments, and interactions with contracted health plans. The role also involves coordinating, processing, and resolving incoming member appeals and grievances, working closely with the Account Management Unit, Claims, and Utilization Management.

Qualifications

Minimum Qualifications:

• At least 2 years of experience in an administrative position.
• Knowledge of CPT, ICD-10, and HCPCS coding procedures and practices.
• Experience creating and manipulating data with spreadsheets and databases using Excel, Access, or similar applications.
• Ability to work collaboratively in a team to achieve goals, solve problems, and meet organizational objectives.

Preferred Qualifications:

• Experience in medical billing/coding, medical documentation improvement, pay-for-performance, or similar programs.
• Experience working with physician offices regarding coding, documentation, or quality measures.
• Associates degree or clinical certification such as Medical Assistant preferred.

Overview

Dignity Health Management Services Organization (Dignity Health MSO) aims to build a system-wide, integrated, physician-centric management service organization. We provide management and business services that leverage economies of scale across provider types and locations, focusing on developing Dignity Health’s Medicaid population health pathways. Our goal is to deliver quality managed care administrative and clinical services to medical groups, hospitals, health plans, and employers, emphasizing patient care and cost containment through industry-leading technology and integrated systems.

Our Total Rewards package offers competitive pay and flexible health & welfare benefits, including medical, dental, and vision plans, HSA, life insurance, long-term disability, a 401(k) plan with employer match, paid time off, and sick leave.

Pay Range

$24.59 - $33.81 per hour