HEDIS Quality Improvement Coordinator – Interamerican Medical Center – Miami Lakes, FL

The HEDIS Quality Improvement Coordinator for the Affordable Care Act (“ACA”) patients has a leading role in the coordination and support of all activities oriented to improve the ACA Quality measures (HEDIS) including patient satisfaction, as well as the execution of daily duties oriented to monitoring PCP compliance with quality specifications and patient compliance with PCP recommendations. The QI Coordinator must be proactive in contacting and educating ACA patients about the benefits of closing gaps in care for preventive care as well as disease maintenance.

Essential Duties and Responsibilities:

• Perform daily evaluations of health plan reports and the IMC Member Level Detail report to ensure proactive identification of patients at risk of non-compliance
• Perform daily review of the scheduled appointments for patients from the ACA line of business (“LOB”) and identify gaps in care. Complete the pre-visit planning to inform providers of gaps in care.
• Conduct post-visit review to ensure gaps in care were addressed.
• Coordinate and support QI activities executed by providers and Medical Assistants of all Medical Centers.
• Ensure proper coordination of activities and operations at IMC medical centers to ensure maximum results, keeping a comprehensive patient approach where all other gaps in care are properly addressed.
• Establish positive and constructive business relationships with health plans, external pharmacies, IMC medical center staff and IMC preferred pharmacy.
• Participate in the training /education of new center staff in quality improvement strategies.
• Provide direct support onsite or telephonically to providers, Center Administrators and staff to ensure high performance on quality metrics.
• Train and motivate staff to effectively address quality-related gaps in care. Identify barriers to productivity and quality; appropriately escalate concerns to management in a timely manner.
• Maintain patients’ performance reports updated.
• Comply with HIPAA requirements for patient confidentiality.
• Provide customer service of high quality maintaining effective, timely and respectful communication with patients, other employees, Medical Assistants and medical professionals.
• Effectively promote the benefits of compliance with preventive care, as well as disease management through the education and monitoring of patients.
• Perform daily telephonic outreach to patients, and/or external providers such as specialists and diagnostic centers to address clinical gaps in care, provide education about compliance with doctor’s recommendations and medication adherence
• Have flexible working hours to contact patients after working hours if needed
• Comply with all health and safety policies of the medical practice,
• Participates in all other QI activities striving for the highest quality performance for IMC.
• Other duties as needed and/or assigned.

Qualifications/Experience:

• High School Diploma or equivalent required
• Minimum of 2 years’ experience as HEDIS/quality coordinator in a primary care setting.
• Knowledge of HIPAA regulations
• Self-motivated and capable of working independently
• Excellent interpersonal and communication skills
• Experience in health promotion or patient education preferred
• Must be proficient in an intermediate degree in Microsoft Office and Excel
• Command of the English and Spanish languages and proficiency with grammar, spelling and verbal skills to effectively communicate with patients, providers and supporting staff

IMC Health prides itself in offering its associates the following:

• Bonus Incentives
• 401K Matching Program
• Medical, Dental and Vision Insurance
• 18 Days of Paid Time Off during first year
• Paid Holidays Off
• Monday through Friday work schedule

EEOE M/F/Veterans/Disabled

Job Type: Full-time

Pay: $16.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Supplemental Pay:

Work Location:

• One location

Company’s website:

• IMCHealth.com

Benefit Conditions:

• Only full-time employees eligible