Quality Improvement Coordinator I
Spectraforce
US
Remote
5 hours ago
Job Description
Position Title: Quality Improvement Coordinator I
Work Location: AZ (Remote)
Assignment Duration: 3 months (Possibility to extend or convert)
Work Schedule: Training 8–5 Mon–Fri (4 weeks, camera on, no time off). Post-training 8–5 Mon–Fri
Job Description-
Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communication with agencies and providers. Collaborative culture. Key project to complete AHCCCS Medicaid QOC investigations.
Systems – Word, teams, outlook, power point, excel, one drive, one note & specialized report system
Resposibilities:
Receive 1-2 QOC investigations daily that are due 60 days from the assignment date. Reviewing medical records, provider policies/manuals and statutes to ensure providers are rendering appropriate care to our members per the guidelines. Writing an investigative report of findings and submitting reports.
Expectation to complete 1 investigative report per day. The role is unique as it requires clinical knowledge to be able to identify quality concerns and develop quality improvement plan to address the concerns with the provider.
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 22.00/hr.
Work Location: AZ (Remote)
Assignment Duration: 3 months (Possibility to extend or convert)
Work Schedule: Training 8–5 Mon–Fri (4 weeks, camera on, no time off). Post-training 8–5 Mon–Fri
Job Description-
Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communication with agencies and providers. Collaborative culture. Key project to complete AHCCCS Medicaid QOC investigations.
Systems – Word, teams, outlook, power point, excel, one drive, one note & specialized report system
Resposibilities:
Receive 1-2 QOC investigations daily that are due 60 days from the assignment date. Reviewing medical records, provider policies/manuals and statutes to ensure providers are rendering appropriate care to our members per the guidelines. Writing an investigative report of findings and submitting reports.
Expectation to complete 1 investigative report per day. The role is unique as it requires clinical knowledge to be able to identify quality concerns and develop quality improvement plan to address the concerns with the provider.
| Candidate Requirements | ||||
| Education/Certification | Required: | Preferred: Bachelor’s degree in nursing or license (COMPACT IS OK) counselor/ SW preferred. | ||
| Licensure | Required: | Preferred: LPN, LVN, RN, PA, LPC, LAC or LCSW license. CPHQ (Certified Professional in Healthcare Quality) preferred. | ||
| Years of experience required: 3+ years of clinical, quality improvement or healthcare experience. MUST have BH or physical health setting experience. 2+ years of experience in quality function in a healthcare setting. Disqualifiers: No clinical BH or physical health experience Additional qualities to look for: Self driven, fast learner, critical thinker | ||||
| 1 | Clinical knowledge | ||
| 2 | Critical thinker, independent work, tech savvy | |||
| 3 | Self driven | |||
Applicant Notices & Disclaimers
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At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 22.00/hr.