Under the supervision of the QI Special Programs’ Manager/ Supervisor, the Quality Improvement Coordinator will be accountable for the daily duties related to achieving deliverables for health plan Quality Incentive Programs across California. The Quality Improvement Coordinator will be responsible for supporting quality management efforts including development, implementation, education, data collection and analysis. Essential Functions: Responsible for fully understanding IHA, HEDIS and assign... more details
Under the supervision of the QI Special Programs’ Manager/Supervisor, the Quality Improvement Coordinator will be accountable for the daily duties related to achieving deliverables for health plan Quality Incentive Programs across California. The Quality Improvement Coordinator will be responsible for supporting quality management efforts including development, implementation, education, data collection and analysis.
Essential Functions:
Responsible for fully understanding IHA, HEDIS and assigned health plan specific quality measures
Responsible for maintaining health plan trackers (e.g., week over week, month over month, year over year)
Assess performance results to identify opportunities and trends that drive strategies, interventions, and outreach efforts
Collaborate with Special Programs Supervisor and Project Manager, internal teams, and health plans to develop strategies, identify and resolve issues / barriers.
Responsible for data mining across all measures, across all health plans and capturing data to close care gaps and improve compliance.
Enters data as outside services into Cozeva to improve compliance and close care gaps.
Assists with data validation (EMR, health plan, Cozeva) to ensure data is aligned and identify opportunities to submit supplemental data to health plans.
Participates in the preparation of and in health plan audits (e.g., IHA, MSSP, PSV).
Assists in program design, implementation, and maintenance of a comprehensive quality improvement program across health plans and related programs.
Assists in educating new caregivers about QI programs, quality measures and compliance requirements.
Partners with internal and external audience on regional outreach campaigns and interventions.
Meets with internal and external audience to identify and problem solve QI issues, if any.
Monitors medical group and affiliated physicians practice efforts to ensure care gaps are addressed and workflows are followed.
Review individual provider performance and provide information on low performing providers to QIS.
Prepare slide decks, graphs, data for meetings and reporting purposes.
Assist coworkers within our department and other departments with projects and tasks as needed.
Follow up on actions required, respond in a timely manner, meet scheduled deadlines, create and implement contingent plans as needed.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
1 year experience in a health care setting or medical
Preferred Qualifications:
PMI Project Management Professional certification upon hire.
5 years experience in a health care or managed care system.
Project management experience in an ambulatory care environment.
Experience with Six Sigma Quality Improvement and Lean Production/Manufacturing processes and tools.
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
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