Quality Specialist

CMP01 Mount Sinai Medical Center of Florida, Inc.; United States; On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability

Healthcare spending accounts

Retirement plan

Paid time off

Pet Insurance

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing

Job summary

Mount Sinai Medical Center is seeking a qualified professional to support the Wellness & Preventive Management program, focusing on HEDIS data abstraction and care-coordination tasks across outpatient settings in South Florida.

You will review records, identify improvements to HEDIS measures, collaborate with leadership, and ensure timely data uploads to health plans. A CMA or RMA certification and a high school diploma are preferred, with a BS degree welcome.

Qualifications

• Certification as CMA or Registered Medical Assistant preferred.
• High School Diploma required.
• Bachelor of Sciences or related field preferred.
• One year of care coordination experience in outpatient settings (HMO/MSO/ACO) preferred.

Responsibilities

• Support Wellness & Preventive Management Program (WPM) including HEDIS.
• Abstract clinical data elements for HEDIS reporting.
• Identify improvements impacting HEDIS measures.
• Review noncompliant reports and flag charts with missing measures.
• Request quality data documentation from outside resources.
• Collaborate with leadership to execute quality strategies.
• Manage reports and monitor performance at group/provider level.
• Engage PCP and clinic staff to close quality gaps.
• Upload HEDIS data to medical records and send to health plan.
• Perform other related duties as assigned.

Skills

HEDIS data abstraction

Care coordination

Quality reporting

Provider engagement

Education

High School Diploma

Bachelor of Sciences degree

Tools

EHR systems

Health Information Systems

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.