Quality Management Coordinator

CommonSpirit Health; Bakersfield (CA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization seeks a Quality Management Coordinator to enhance clinical quality functions across its enterprise. This remote role involves data management, member interaction, and collaboration with various departments to improve healthcare delivery. Candidates should have administrative experience and knowledge of coding procedures.

Qualifications

• 2+ years experience in an administrative position.
• Knowledge of current CPT, ICD-10, and HCPCS coding procedures.
• Experience in creating and manipulating data with spreadsheets and/or databases.

Responsibilities

• Assist in promoting QM activities related to monitoring and improving performance.
• Coordinate, process, and resolve incoming member appeals and grievances.
• Facilitate committee meetings and collaborate with other departments.

Skills

Data collection

Data entry

Team collaboration

Education

Associates degree or clinical certification

Tools

Excel

Access

Job description

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Position Summary

The Quality Management Coordinator will be a part of the Quality Management department. The Risk Management and Quality Improvement department works to measure and improve clinical quality functions across the enterprise. Under the direction of the Manager of Quality Administration, the Quality Management Coordinator will assist in promoting QM activities related to monitoring, assessing, and improving performance in healthcare delivery and services to plan members. Duties include data collection, data entry, record maintenance, chart audits, member mailings, committee facilitation, collaboration with other departments, and interaction 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.

Responsibilities

• This position is remote.

Qualifications

Minimum Qualifications

• 2+ years experience in an administrative position.
• Knowledge of current CPT, ICD-10, and HCPCS coding procedures and practices.
• Experience in creating and manipulating data with spreadsheets and/or databases using Excel, Access, or similar programs.
• Willingness to work as part of 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 physicians' offices regarding coding, documentation, or quality measures.
• Associates degree or a clinical certification, such as medical assistant, preferred.