Clinical Quality Support Specialist

Job Summary

This position works under the direction of the Manager, Clinical Quality to provide non-clinical support for the Clinical Quality Department. Manages incoming and outgoing correspondence. Prepares documents and compiles data for meetings and workgroups. Tracks and conducts follow up to obtain requested documents for PQI review or focused studies.

Education & Experience

• Required: High School Graduate or G.E.D.
  • 3+ years administrative experience or equivalent
• Experience in a medical office, health insurance, or managed care organization
• Proficient with Microsoft Excel, Word, Outlook
• Preferrable: Associates Degree in Business or Administrative Services
• Microsoft OneNote experience
• Letter writing experience

Key Responsibilities

• Orders/receives medical records for Potential Quality Issues (PQI and CQM Department activities according to desk procedures, conducts follow-up telephone calls to providers, and completes other processes to resolve missing documents)
• Obtains, prepares and distributes materials for quality meetings. Workgroups and projects as directed.
• Maintains all CQM department files to meet TriWest confidentiality and security requirements.
• Processes invoices for medical records received. Follows up, as needed, with the Finance/Accounting Dept.
• Processes incoming and outgoing mail and faxes, correspondence for overnight or certified delivery, and other mailing needs.
• Participates in department meetings and work groups, serving on quality improvement committees as needed.
• Performs other duties as assigned.

Competencies

• Communication / People Skills
• Computer Literacy
• Coping / Flexibility
• Empathy / Customer Service
• Independent Thinking / Self-Initiative
• Multi-Tasking / Time Management
• Organizational Skills
• Team-Building / Team Player
• Technical Skills

Working Conditions

• Works in a standard office environment, with no travel
• Extensive computer work with prolonged sitting
• May require occasional evening meeting attendance

Company Overview

Taking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team!

We’re On a Mission to Serve®! Our job is to make sure that America’s heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $42,000 - $45,000 per year.

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply.

Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.