Remote Clinical Quality Improvement Coordinator
$58,240–$62,400 year
RemoteUnited States
Job Summary
Conduct proactive patient outreach to identify quality gaps, schedule screenings, and facilitate treatment adherence while collecting quality data from EMRs, claims, and provider records. Manage daily workflows across multiple systems including EMR platforms, payer portals, and Microsoft 365 applications to ensure accuracy in NCQA/HEDIS specifications and quality measure reporting. Prioritize tasks to meet strict quality reporting deadlines and communicate performance metrics and improvement strategies to customers and internal teams. Collaborate with payers, providers, and cross-functional staff to support commercial and governmental payer initiatives.
Required Qualifications
- Associate degree or greater in related field or certified/licensed professional-CMA, LPN
- Minimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction via EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding
- Minimum 2 years' experience in Medicare Advantage Quality data abstraction and patient outreach
- Tech savvy in managing the technical side of this position-working with health data, working in excel and PowerPoint, navigating multiple systems and applications
- Highly skilled in verbal and written communications
- Strong attention to detail, organized and ability to meet hard deadlines
- Ability to collaborate w/ others and work effectively with management, co-workers, and customers
- Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers
- Extensive experience with quality database entries and reporting
- Experience in interpreting and reporting quality information, as well as training staff
- Proficiency in Electronic Medical Record (EMR) software and cloud platforms
- Minimum 100 mbps download, 10 mbps upload internet connection
Desired Qualifications
- Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers
- Extensive experience with quality database entries and reporting
- Experience in interpreting and reporting quality information, as well as training staff
- Proficiency in Electronic Medical Record (EMR) software and cloud platforms
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