Value Based Clinical Quality Coordinator

El Centro Family Health; Santa Fe (NM); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

401(k) Retirement Plan

7 Paid Holidays

Paid Sick Time

Comprehensive Medical, Dental, and Vis

100% Employer-Paid Basic LifeInsurance

Voluntary Employee Supplemental Benefi

Employee Assistance Program (EAP)

Education Reimbursement

Flexible Spending Account (FSA)

Job summary

El Centro Family Health seeks a Value-Based Clinical Quality Coordinator to promote consistency and streamline processes across provider groups, driving quality performance and improved patient outcomes.

The role partners with market teams and leadership in a matrixed environment to implement best practices and support quality initiatives. RN/ADN background preferred with EMR fluency.

Qualifications

• Three years of care operations, provider reimbursement, analytics, or value-based care.
• At least four years of overall healthcare experience.
• Two years in provider-facing roles.
• Proficiency in Microsoft Office applications (Outlook, Word, PowerPoint, Excel).
• ADN with an active RN license in NM or a compact state; LPN with HEDIS/Star exp also considered.
• Ability to interpret clinical data and provide actionable recommendations.
• Valid New Mexico driver's license.

Responsibilities

• Conduct medical record reviews, data collection, data entry, and chart retrieval to close care gaps.
• Collaborate with Clinical Quality, Network Management, and Risk Education teams to identify trends and strategies.
• Monitor barriers within the region and propose solutions to improve outcomes.
• Navigate multiple EMR systems to retrieve documentation for quality initiatives.
• Maintain up-to-date knowledge of HEDIS and Star measures.
• Perform additional duties to support organizational goals.

Skills

MS Office

RN license NM

Data interpretation

Healthcare analytics

Education

Associate Degree in Nursing (ADN)

LPN + 5+ years HEDIS/Star experience

BSN (preferred)

Tools

EMR systems

Job description

Job Description

Job Description

Position Overview

The Value-Based Clinical Quality Coordinator is responsible for promoting consistency, streamlining processes, and sharing best practices across assigned provider groups to achieve a minimum 4-star quality performance. This role works directly with providers and participates in quality improvement initiatives to enhance patient outcomes. The Coordinator is accountable for quality performance within their designated region and collaborates closely with market teams and leadership in a matrixed environment.

What You Will Do

• Conduct medical record reviews, data collection, data entry, and chart retrieval to identify and close gaps in care and improve HEDIS/Star ratings.
• Collaborate with Clinical Quality, Network Management, and Risk Education teams to identify trends and develop strategies to support assigned practices.
• Monitor and analyze barriers within the assigned region, recommending solutions to improve outcomes.
• Navigate multiple electronic medical record (EMR) systems to retrieve documentation and support quality performance initiatives.
• Maintain up-to-date knowledge of HEDIS and Star performance measures.
• Perform additional duties as assigned to support organizational goals.

Minimum Qualifications

• Three years of experience in care operations, provider reimbursement, analytics, or value-based care.
• At least four years of overall healthcare experience.
• Two years of experience in provider-facing roles.
• Proficiency in Microsoft Office applications, including Outlook, Word, PowerPoint, and Excel.
• Associate Degree in Nursing (ADN) with an active RN license in New Mexico or a compact state; alternatively, a Licensed Practical Nurse (LPN) with 5+ years of HEDIS/Star program experience may be considered.
• Ability to interpret clinical data and provide actionable recommendations for improvement.
• Valid New Mexico driver's license.

Preferred Qualifications

• Two years of experience with HEDIS/Star programs, preferably in a clinical quality or consulting role.
• Experience in data analysis, chart review, and clinical abstraction.
• Knowledge of billing practices and CPT coding.
• Bachelor of Science in Nursing (BSN).
• Experience with Medicare and/or managed care programs.

Physical Requirements

• Ability to balance, bend, lift, carry, and pull up to 20 lbs.
• Ability to sit and stand for extended periods, typically longer than four hours.
• Flexibility to work a varied schedule, including evenings, weekends, or as needed.
• Manual dexterity and ability to use hands and fingers for feeling, grasping, and operating office equipment.
• Adequate hearing ability for communication and monitoring office environments.
• Good vision for reading documents, operating office equipment, and observing surroundings.
• Capability to stoop, crouch, crawl, or kneel as necessary for office tasks.
• Ability to talk clearly and effectively for communication.
• Ability to walk and move around the office environment.

What We Offer

• 401(k) Retirement Plan
• 7 Paid Holidays
• Paid Sick Time
• Comprehensive Medical, Dental, and Vision Insurance
• 100% Employer-Paid Basic Life Insurance
• Voluntary Employee Supplemental Benefits
• Employee Assistance Program (EAP)
• Education Reimbursement
• Flexible Spending Account (FSA)

Who We Are

As a Federally Qualified Health Center (FQHC) and 501(c)(3) nonprofit, El Centro Family Health is dedicated to providing affordable, accessible, and high-quality healthcare to the people of Northern New Mexico. Our mission is to enhance the quality of life in our community by delivering primary care and health education through a network of clinics and collaborative programs. At El Centro, we are committed to offering vital health services in a compassionate, supportive, and patient-centered environment.

Equal Employment Opportunity Statement

El Centro Family Health is an equal opportunity employer. We do not discriminate based on race, color, religion, gender, gender identity, sexual orientation, national origin, disability, age, veteran status, or any other protected characteristic. We are committed to fostering a diverse and inclusive workplace for all.