Quality Specialist

Mount Sinai Medical Center; Florida; On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability coverage

Healthcare spending accounts

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Job summary

Mount Sinai Medical Center seeks a Care Coordination professional to support the Wellness & Preventive Management Program, focusing on HEDIS data abstraction, annual wellness visits, and care coordination tasks in an outpatient setting.

You will collect and verify medical data, drive improvements in quality measures, and collaborate with leadership, PCPs, and clinic staff to close gaps and ensure accurate reporting to health plans.

Qualifications

• Certification as CMA or Registered Medical Assistant preferred.
• High School Diploma required.
• Bachelor of Sciences degree preferred or related field.

Responsibilities

• Support Wellness & Preventive Management Program (WPM) including HEDIS, annual wellness visits and care coordination tasks.
• Abstract clinical data elements from records for HEDIS reporting (e.g., labs, hypertension readings).
• Collect data, identify improvements impacting HEDIS measures and flag gaps.
• Coordinate with leadership to execute quality strategies and close gaps with PCPs and clinic staff.
• Upload HEDIS data to medical records and transmit to health plans.

Skills

HEDIS data collection

Care coordination

Quality improvement

Outpatient care

Education

High School Diploma

Bachelor of Sciences (preferred)

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, 24/10 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 Way Our 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.

Job Description Summary:

Position Responsibilities:

• Responsible 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 assigned.

Qualifications:

License/Registration/Certification Preferred Certified Medical Assistant or Registered Medical Assistant. Education Required: High School Diploma. Preferred: Bachelor of Sciences degree or in other related field, foreign medical graduate Experience Preferred: 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 benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet Insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for select positions and more!

Degree Requirements: Certification:

More than 4,000 people work at Mount Sinai Medical Center at more than a dozen locations throughout sunny South Florida, including our flagship, 672-bed hospital on Biscayne Bay at the gateway to Miami Beach. We're the largest, independent, not-for-profit hospital in South Florida, and we're the only hospital Healthgrades recognized for four years running as one of the top 5% in the nation. Clearly, clinical excellence is at our core.