Quality Improvement Specialist

POSITION SUMMARY:

Under the direction of the Quality Manager, the Quality Improvement Specialist will be responsible for leading quality and process improvement projects in an effort to increase clinical performance measures. The Quality Improvement Specialist is a non-clinical team member who is skilled at engaging patients over the phone and in-person and working with clinical care teams to enhance care in selected areas. The essential functions of this position include but are not limited to the following:

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Provides support in the organizations quality improvement efforts and performance improvement activities which includes: data monitoring, and facilitation of quality improvement projects.
• Works with key stakeholders from the clinical care team to improve our performance on various UDS, HEDIS, and other metrics/quality indicators.
• Serves as the quality improvement team lead and is responsible for communicating progress of quality improvement projects to the clinical care team.
• Collects and analyzes data to identify opportunities, and/or barriers.
• Works alongside key stakeholders from the clinical care team to implement interventions clinic-wide that address problem areas.
• Tracks, measures, and maintains comprehensive project documentation for all assigned projects and submits regular progress reports to the Quality Manager.
• Tracks certain diagnostic tests and referrals relating to metrics/quality indicators; including contacting other clinics for records and locating past medical records to enter them correctly in the electronic health record.
• Travel to clinics and sites of APLA Health & Wellness to participate in various Quality Improvement activities and meetings.
• Protects patients' rights by maintaining strictest confidentiality of personal and financial information; adhering to all HIPAA guidelines/regulations.
• Maintains operations by following policies and procedures; reporting needed changes.
• Assist in maintaining office and building fire/safety regulations.
• Ensures clinic flow by being an active team member.
• Practice active listening, empathy and cultural humility with patients to schedule appointments and address challenges of patients at-risk of missing appointments.
• Outreach to patients and assist patients with accessing additional resources and/or clinical services, including transportation and interpretation services.
• Coordinate appointments with health care providers to ensure timely delivery of diagnostic and treatment.

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

REQUIREMENTS:

Training and Experience:

High school diploma or GED required and at least two (2) years of experience working in a medical office or similar environment preferred. Must be extremely organized and detail oriented and have excellent communication skills, project management skills, and strong telephone etiquette. Must have a courteous, professional nation and be customer service oriented. Strong computer skills required.

Knowledge of:

Demonstrate an understanding of culturally specific challenges and disparities facing patients. Efficient in demonstrating essential job related functions and workplace etiquette. Knowledge of HEDIS measures and HRSA standards strongly preferred. Knowledge of basic public health principles, managed care, health care delivery systems and communities served, specifically, but not limited to LGBT and individuals living with and/or at-risk of HIV. Basic understanding of health risk factors, prevention techniques, and healthy lifestyles. Knowledge of electronic health records - eClinicalWorks preferred. Knowledgeable about insurance plans, Medi-Cal/Medicare. Strong working knowledge of Microsoft Office programs.

Ability to:

Apply critical thinking and problem solving skills. Must be able to identify mandatory reporting situations. Able to work effectively within a team, demonstrate initiative, follow-through and accountability. Must be able to set goals and develop work plans. Able to maintain a strict discipline in time management with a focus on quality.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

SPECIAL REQUIREMENTS:

Must possess a valid California drivers license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes. COVID-19 Vaccination or Medical/ Religious Exemption required.

Equal Opportunity Employer: minority/female/disability/veteran.