Quality Improvement Assistant is responsible for assisting in carrying out quality improvement processes. This will include but is not limited to recording audit reviews and utilization reviews. Within federal, state, and local guidelines, the Quality Improvement Assistant will assist in performing routing work, including data entry, Electronic Health Record (EHR) review, assisting with administering internal quality assurance and compliance activities, and assisting with quality assurance audits of health outcomes, as defined by the Uniform Data System (UDS), Patient Centered Medical Home (PCMH), and organizational goals.
Job duties include:
- Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.
- Supports effective medical record capture for HEDIS medical review and abstraction of supplemental data.
- Provides care coordination for assigned patients by coordinating patient appointments.
- Responsible for completing outreach and subsequent intake activities using required forms and documents.
- Conduct patient telephone outreach and engagement, on-going emerging needs and to promote continuity of care and improved health outcomes.
- Follow up with Hospitals/ER upon notification of admission or discharge and coordinate with health care team to facilitate communication of the event and transition of care services, to include, but not limited to medication reconciliation with health care team as per policy.
- Assist patient in developing plans and community supports to overcome obstacles that would prevent them from receiving needed services/referrals.
- Assist with preparation of evaluation reports
- Develops systematic approaches to identify data errors and service trends.
- Assist with patient satisfaction surveys, including, but not limited to; working directly with patients and staff, compiling results, and entering data.
- Performs other job duties as assigned.
- High school diploma or GED required. Associate degree in Medical or related field preferred.
- Certified Medical Assistant or Licensed Practical Nurse (LPN) with minimum two (2) years’ experience.
- Ability to use computers and Windows based software to enter data and develop reports as needed.
- Excellent writing, communication, and organizational skills.
- A passion for serving patients, and their families.
- Proven self-management abilities, including meeting deadlines.
- Knowledge of medical terminology.
Please visit https://www.community-healthnet.com/employment/ to apply!