Hybrid Quality Coordinator Lead presso UNLV Health

The Quality Coordinator Lead is responsible for ensuring that the collection of Healthcare Effectiveness Data and Information Set (HEDIS), and other insurance quality programs are accurate, efficient, timely, and within compliance guidelines. The quality coordinator lead will monitor and report on all activities, processes, and procedures that are being implemented to ensure a high level of excellence. This position will be responsible for conducting or assisting with regulatory and quality training sessions while preparing and developing internal auditing tools and conducting internal audits and reports. The quality coordinator lead will drive regular inspections through random audits and reviews to ensure that the other quality coordinators are adhering to and meeting set benchmarks.

Candidates must be legally authorized to work in the United States. Please Note: UNLV Health does not provide employment sponsorships or sponsorship transfers for any positions.

ADVANTAGES OF WORKING FOR UNLV HEALTH

• Clinic Hours are Monday through Friday, 8AM to 5PM!  (Actual hours may vary depending on business need)
• 12 Paid Holidays per year, starting with your first day of employment!
• 20 + PTO days per year! (Depending on Position)
• 3% 401K Contribution, even if you do not contribute!
• Medical, Dental, and Vision benefits that start the first of the month following your start date!
• And more!

MAJOR RESPONSIBILITIES

The quality coordinator lead will drive quality improvement through building trusting partnerships, elevating a culture of change through data driven excellence, while improving healthcare quality initiatives. The quality coordinator lead will be responsible for setting strategic goals and carrying out those goals by establishing and maintaining an efficient and responsive quality team. 

HEDIS/Quality Metrics

• Research any discrepancies found by reviewing electronic health records (EHR) and any other relevant information 

• Identify trends and document any errors found such as CPT 2 codes not dropping. Reporting out this information as soon as it becomes available to the Executive Leadership team

• Applying structured auditing criteria to the EHR to determine compliance with HEDIS and Quality metrics setting, meeting, and exceeding those targeted benchmarks 

• Demonstrate expertise in the requirements and parameters of mandated HEDIS and Quality performance measures

• Provide participation program requirements within the EHR and report to the individual departments and executive leadership.

• Coordinate, monitor, and report progress toward completion of quarterly  HEDIS/Quality chart abstraction process 

• Demonstrate a wide knowledge base to all of the payer insurance portals and be the key person for the physician clinics to train best practice for utilizing portals to meet quality metrics by submitting data through the portal sites. 

• Coordinate HEDIS/Quality processes and establish a plan to improve quality scores. This will include setting strategic goals with targeted benchmarks for not only the lead role, but for the other quality coordinators in their role with the understanding that this organization values all quality initiatives

• Responsible for data collection from automated and manual sources. This requires the ability to import and manipulate electronic data. 

• Must be able to work autonomously on assigned projects and be able to provide status reports on a moment's notice. 

• Performs other duties as assigned

Quality Control Audits: 

• Works with the Executive Director, Payers, and the departments to report/monitor HEDIS/Quality program requirements and progress weekly/ monthly.

• Reviews daily, weekly, and monthly key metrics to identify trends or areas of focus; works with the Executive Director of Clinical Operations to develop, document, and implement action plans, as appropriate, to address issues

Training:

• Identifies opportunities for HEDIS/Quality/revenue improvement, automation, or issue resolution. 

• Creates and provides data to baseline and drive solution outcomes

• Assimilates new staff into the department and provides ongoing training for the existing team

• Attends huddles in all of the clinics and provides education that will help build a culture of understanding 

Coordinate Workflow: 

• Provides Executive Leadership  with information regarding HEDIS/Quality status reports 

• Implements improvements in the work process that both improve the efficiency and effectiveness of the physician clinics

Service Excellence:

• Treats patients, staff, and others with dignity, respect, and fairness

• Delivers exceptional customer service during all interactions and will promote the patient experience through utilizing Press Ganey 

• Serves with compassion and humility, acts with genuine care and concern for others

• Communicates with honesty and transparency

• Works as an effective and cooperative team member

• Is receptive to constructive feedback

• Contributes to a culture of inclusion

• Acts with integrity and ensures that words, deeds, and actions are aligned

• Comply with all departmental and company policy and procedures

• Completes any duties and special assignments as requested

EXPERIENCE, EDUCATION, AND CERTIFICATIONS

• Minimum of three (3) years of experience in Healthcare, Medical Assistant, and/or related field required

• The National Association for Healthcare Quality (NAHQ), Certified Professional in Healthcare Quality (CPHQ) certification required within 1 year of hire 

• High School Diploma or GED equivalency required

• Graduate from a recognized Medical Assistant program required

• Medical Assistant Certification required (certification must be obtained within 90 days of hire)

• Basic Life Support (BLS) Certification required

   

KNOWLEDGE, SKILLS, AND ABILITIES QUALIFICATIONS

• Intermediate knowledge of medical terminology, anatomy, and physiology

• Intermediate knowledge of Microsoft Office and Google Workspace

• Demonstrated proficiency in Microsoft Office (Word, Excel, etc.) and Google Suite (Gmail, Docs, etc)

• Strong critical thinking and problem solving skills

• Excellent verbal and written communication skills

• Basic understanding of population health and data analytics 

• Must be able to work independently with minimal supervision

• Must be able to multitask and prioritize work in a fast paced environment

• Must be able to maintain confidentiality

• Must be able to pay close attention to details and well organized

  
  

PHYSICAL REQUIREMENTS

• May include standing, sitting, and/or walking for extended periods

• May include performing repetitive tasks

• May include working on a special schedule (i.e. evenings and weekends)

• May include working with challenging patients and clients

• May include lifting up to 25 pounds 

UNLV Health will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.

If you have any questions about our interview and hiring procedures, please contact Recruitment at  [email protected]