Quality CoordinatorApply Job ID 16006 Date posted Nov. 27, 2019 Location Sussex, Wisconsin Full Time / Part Time Full time (FT)
GENERAL PURPOSE OF JOB
This is a professional position that is responsible for coordination, implementation and updating of QuadMed’s Quality Plan. This includes development of monitoring and improvement activities for positively impacting and improving patient outcomes in care delivery. This position will have a focus on Provider metrics and Medical Group activities. Responsibility of coordinating Medical Staff activities and acts as liaison between the Medical Staff and Senior Leadership within the parameters established by the assigned Medical Leader and the Clinical Quality Director. Responsible for the oversight and adherence of Governing bylaws, and QuadMed policies and procedures. The Quality Coordinator assists with quality/risk management functions related to medical staff.
Coordinates Medical Staff activities and Medical Staff Office:
Responsible for all medical staff meetings. Oversees and assures compliance of monthly committees, department and Medical Staff meetings as addressed in Medical Staff Bylaws/Rules and Regulations. Oversees/prepares agendas and minutes ensuring proper documentation and follow-up from meetings. Assures overall continuity of Medical Staff activities, including expeditious follow-up on action items and policy changes within appropriate committee structure. Prepares monthly report for Medical Executive Committee (MEC), forwarding appropriate reports from each Medical Staff Committee/Department as appropriate. Provides summary of Medical Staff for all activities and incorporates information into agendas for all Department and General Medical Staff Meetings.
Exhibits responsibility for confidential matters at all times
Initiates, oversees, and maintains confidential research requirements for credentialing activities In collaboration with the credentialing specialist
Performs monthly review of completed initial appointments to assure that files are assembled and items verified according to policy and in accordance with Medical Staff Bylaws.
Organizes Credentials Committee Meeting forwarding reappointments from summary of new applications, and requests for changes and/or additions in privileges, and/or any other items requiring Credentials Committee approval.
Assists in processing of temporary privileges with all appropriate documentation.
Acts as a back up support for credentialing and licensing in the event of vacations, leaves of absence or vacancy.
Maintain working knowledge of Medical Staff Bylaws, AAAHC standards, NCQA, Federal, and State regulations.
Schedules Bylaws Committee Meetings (when appropriate); researches bylaws, suggests recommendations, etc. Works with Medical leader and Clinical Quality Director to ensure that Medical Staff Rules and Regulations meet the current standard of practice.
Responsible for chart routing, reporting from chart reviews, auditing compliance with state requirements, awareness of state regulations on a state by state basis, and assisting with selection of new oversights and their onboarding.
Collaborates with Clinical Quality team in administrative management of the PQRC and peer review process.
- May perform other duties as necessary
Assists in the development of Standard Operating Procedures within QuadMed
All QuadMed providers and non QuadMed employed providers
Associate’s Degree Healthcare or Business Administration, or equivalent knowledge in medical staffing office experience.
Minimum 2 years recent experience with process improvement or working in quality. Medical staff office or quality experience preferred.
Previous experience with multi state regulations and federal regulations a bonus
Experience managing online resources (websites, data warehouses, etc.) and leading committees, workgroups and multi-disciplinary teams preferred
Previous experience in credentialing, privileging or medical staff office a plus.
Certificates, Licenses, Registrations:
Certification in quality improvement or project management
- Lean certification a plus
CPHQ certification a plus
Knowledge, Skills & Abilities:
Knowledge of performance improvement methodologies, with capacity for policy and procedure development
Able to communicate clearly and effectively, both verbally and in writing, with a broad range of professionals and people of varying education and backgrounds.
Ability to adapt to changing schedules, deadlines and demands, while balancing a heavy workload.
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