Quality Specialist

Mount Sinai Medical Center; Town of Florida (NY); On-site; USD 48,000 - 72,000; Full time

Benefits offered by this job

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

Job summary

Mount Sinai Medical Center is seeking a Care Coordination/Quality Specialist to support the Wellness & Preventive Management Program (WPM) by abstracting HEDIS data from medical records and coordinating care improvements. You will help ensure accurate reporting and drive quality initiatives in outpatient settings.

The role involves working with leadership, PCPs, and clinics to close gaps, upload data to health plans, and monitor performance across groups and providers.

Qualifications

• HEDIS data abstraction experience.
• Care coordination in outpatient setting preferred.
• Bachelor's degree preferred; high school diploma required.

Responsibilities

• Support Wellness & Preventive Management Program (WPM).
• Abstract clinical data for HEDIS reporting from medical records.
• Identify improvements affecting HEDIS measures.
• Flag missing measures in charts; request documentation.
• Collaborate with leadership to implement quality strategies.
• Manage reports and monitor performance at provider level.
• Engage PCP and clinic staff to close quality gaps.
• Upload HEDIS data to medical records and to health plans.

Skills

HEDIS data abstraction

Care coordination

Data analysis

Medical records review

Education

High School Diploma

Bachelor's degree preferred

Foreign medical graduate

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 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.

Department

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

• 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!