Quality Care Coordinator

Responsibilities

• Conducts outreach (inbound/outbound calls, texts, portal messages, scheduling appointments) to members to encourage timely access to appropriate care, address open care gaps and increase HEDIS/STAR scores.
• Documents detailed conversations and maintains EHR information for assigned member workload to ensure accurate tracking and follow up.
• Runs, analyzes and maintains reports from EHR and other databases to prioritize targeted member outreach and scheduling.
• Prepares patient charts for visits and communicates with provider regarding care gaps to ensure compliance and adherence to quality measures.
• Provides patients with information and instructions regarding medications, labs and screenings.
• Identifies and reports potential barriers to compliance recognized during communication with members.
• Provides culturally and linguistically appropriate general education to members to encourage health literacy.
• Affords assistance with special projects as needed related to achievement of HEDIS/STAR goals.
• Attends departmental meetings and meetings with external partners to drive quality improvement initiatives.

Qualifications

• High school diploma or equivalent required.
• Certified Medical Assistant or LPN Certification strongly preferred.
• Minimum of 2 years’ experience working in a healthcare clinic setting.
• Minimum of 12 months experience in a customer service position.
• Excellent communication and customer service skills.
• Demonstrated initiative, ability to work collaboratively and good professional judgment.