Universal American
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QI Coordinator

Job Title
QI Coordinator
Job ID
663355
Begin Date
1/17/13
Duration
Location
Mechanicsburg, PA,  
Other Location
Description
Program overview
Universal American/APS Healthcare is managing a portion of the DC Chartered Health Plan, which provides complex case management services and supports high risk/ high cost members with chronic illness through field case management, transitional care and medical care coordination. This program supports and assists TANF and low-income and childless adults not eligible for Medicaid members in becoming and staying healthy by coordinating treatment coverage, reinforcing treatment plans and by educating patients on making responsible decisions about their healthcare.
 
Position description
As a Quality Improvement Coordinator you will assist the QI Manager and/or the Regional QI Manager in the coordination and implementation of the local site quality improvement program that meets or exceeds all quality regulatory and accreditation standards. Responsibilities also include assisting with the complaint, appeals, adverse incident, training scheduling and reporting processes.

Essential Functions:
• Acknowledges and assists with the receipt of complaints, appeals and adverse incidents, tracks the disposition, ensures that all timeframes are met, ensures resolution, follows all policies regarding the processes and generates reports.
• Assists QI Manager and/or Regional QI Manager in the coordination and implementation of the local site quality improvement program that meets or exceeds all quality regulatory and accreditation standards.
• Compiles and generates contract performance indicator and contractually required reports.
• Assists in the preparation and maintenance of URAC/NCQA accreditation.
• Collects a variety of data (complaints, clinical document auditing, call statistics, etc.), maintains databases (complaints, training logs, etc.) and assists in identifying opportunities for improvement.
• Schedules and participates in trainings and meetings.
• Provides administrative support.

Education:
• High School Diploma required
• Associates degree in Healthcare related field preferred
• OR
• High School Diploma required
• A minimum of 4-6 years of related experience required

Qualifications:
• Minimum 3 to 5 years customer service or related experience
• Experience in the healthcare field a plus
• Experience with data collection and reporting a plus
• Intermediate Microsoft Office skills.
• Strong written and verbal communication skills.
• Strong organizational skills and attention to detail.
• Strong office administrative skills.
• Interpret data to write reports and assist in identifying trends.
• Use problem solving skills to overcome barriers
Required Skills

Education:
• High School Diploma required
• Associates degree in Healthcare related field preferred
• OR
• High School Diploma required
• A minimum of 4-6 years of related experience required

Qualifications:
• Minimum 3 to 5 years customer service or related experience

Openings
1

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