Quality Specialist

Mount Sinai Medical Center; Florida; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability coverage

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Job summary

Mount Sinai Medical Center in Miami, FL seeks a qualified professional to support the Wellness & Preventive Management Program. The role focuses on HEDIS data abstraction, annual wellness visits, and care coordination tasks across departments.

Responsibilities include reviewing medical records for HEDIS measures, collecting data, closing quality gaps with PCPs, uploading data to records, and coordinating with health plans.

Qualifications

• Reviews medical records to abstract data for HEDIS measures.
• Identifies improvements to meet quality measures.
• Collaborates with leadership to implement quality strategies.
• Uploads HEDIS data to medical records and transmits to health plans.

Responsibilities

• Support the Wellness & Preventive Management Program (WPM): HEDIS, Annual Wellness Visits, Appointments, and other care coordination tasks.
• Review assigned medical records to abstract clinical data elements for HEDIS reporting.
• Collect medical record data and identify needed improvements that impact HEDIS measures.
• Review noncompliant reports and flag patient charts with missing measures.
• Request quality data documentation from outside resources.
• Work with leadership to execute quality strategies and monitor performance at group/provider levels.
• Engage PCPs and clinic staff to close quality gaps.
• Upload HEDIS data to medical records and send to the health plan.
• Perform all other related duties as assigned.

Skills

Care coordination

HEDIS data abstraction

Medical records review

Data collection

Education

High School Diploma

Bachelor of Science degree

Job description

As Mount Sinai grows, so does our legacy in high-quality health care.Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.Culture of Caring: The Sinai WayOur hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.Department:Job Description Summary:Position ResponsibilitiesResponsible for supporting the Wellness & Preventative Management Program (WPM): HEDIS, Annual Wellness Visits, Appointments, and other Care Coordination tasks.Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting, e.g. results of laboratory tests, verification of hypertension and the most recent blood pressure reading.Collect medical record data and identify needed improvements that impact HEDIS measures.Review noncompliant reports and flags patient’s charts with the missing measures.Request quality data documentation from outside resources.Works closely with leadership to execute quality strategies.Manage the reports and monitors performance at group and providers level.Engages PCP and clinic staff in developing strategies to close quality gaps.Upload HEDIS data to medical records and send it to the health plan.Performs all other related duties as assignedQualificationsLicense/Registration/CertificationPreferred Certified Medical Assistant or Registered Medical Assistant.EducationRequired: High School Diploma. Preferred: Bachelor of Sciences degree or in other related field, foreign medical graduateExperiencePreferred: One year of experience in Care Coordination in outpatient setting or HMO, MSO or ACO.Benefits:We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:Health benefitsLife insuranceLong-term disability coverageHealthcare spending accountsRetirement planPaid time offPet InsuranceTuition reimbursementEmployee assistance programWellness programOn-site housing for select positions and more!Degree Requirements:Certification: