Healthcare Quality Coordinator | Provider Outreach & Compliance

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Quality Management Coordinator provides administrative and clerical support as well as project coordination within the quality management department.

Job Duties/Responsibilities:

• Responsible for data collection related to QM initiatives
• Performs outreach to Providers to ensure regulatory required compliance is maintained
• Coordinates and conducts activities with Providers, External Vendors or Internal Departments as needed.
• Aggregates data and initial analysis of results on assigned projects
• Produces charts, graphs, and reports to demonstrate results and outcomes
• Maintains up-to-date databases and tracking logs
• Requests medical records to support quality review activities, conducts phone and fax follow-up, troubleshoots, investigates, follows up on retrieval of missing information and collaborates with clinical staff on patient safety issues
• Other duties and special projects as assigned

Job Requirements:

Experience:

Required:

• 1+ year of experience in a medical office, health plan or hospital environment performing clerical supportive duties
• Managed care experience
• 2+ years’ professional experience with MS Office Suite- Word, Outlook, Excel, Access

Education:

Required:

• High School Diploma or GED
• Six months+ related experience and/or training

Preferred: Associate degree

Specialized Skills:

Required:

• Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Mathematical Skills:  Ability to perform mathematical calculations and calculate simple statistics correctly
• Reasoning Skills:  Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
• Problem-Solving Skills:  Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Report Analysis Skills:  Comprehend and analyze statistical reports.

Other:

Required:

• Work independently and as a part of an integrated team
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.  While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $53,210.00 - $79,815.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.