QUALITY IMPROVEMENT COORDINATOR - LIBERTY ADVANTAGE

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We are currently seeking an experienced:

QUALITY IMPROVEMENT COORDINATOR – LIBERTY ADVANTAGE

Full Time

JOB SUMMARY:

• Assists with collecting, compiling and reporting of QI data for both I-SNP and C-SNP programs.
• Performs comprehensive, concurrent, and retrospective reviews in a timely manner, utilizing QI plan
• Collaborate with team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)
• Versed in HEDIS technical specification
• Ability to abstract medical record information in accordance with HEDIS specifications, which may include research in claims and other systems to find needed information.
• Provides care for assigned I-SNP and C-SNP patients in collaboration with provider.
• Conducts assessments for assigned patients based on the model of care requirements.
• Completes acute assessments to evaluate patient conditions.
• Focus on early identification of changes in condition and communicate findings to practitioner.
• Communicates effectively with any transition of care.
• Documents patient assessment and directed plan of care in the electronic medical record.
• Reviews appointments, labs and diagnostic tests communicating pertinent results to practitioner for additional interventions
• Collaborates with members of IDT for coordination of care
• Communicates with patients and/or family monthly or quarterly as condition dictates.
• Utilizes strong communication skills and focus on customer needs and services.
• Assists with any patient emergency as needed.
• Recommends and/or conducts specific areas of in-service or continuing education with patients and caregiver as appropriate.
• Assists with compliance of quality measures for assigned members
• Participates with ICT meetings for assigned members
• Completes initial and annual HRA's and corresponding care plans for assigned members
• Performs other duties as assigned.

JOB REQUIREMENTS:

• Graduated from an accredited Registered Nurse (RN) program
• Current RN licensure in state of practice
• Current BLS certification
• Minimum 2 years clinical experience as a Registered Nurse (RN) in geriatric, adult or family practice setting
• Pertinent clinical work experience relevant to the population being served.
• Must be able to demonstrate computer skills, including use of e-mail and Microsoft office word and excel
• Must be able to demonstrate effective written communication skills including but not limited to writing reports and correspondence
• Must be able to demonstrate effective verbal communication skills, including but not limited to speaking effectively to members, providers, families and staff and listening to members, providers and families
• Demonstrate ability to meet deadlines, and use time effectively and efficiently.
• Demonstrate successful experience working in an environment of change. Effectively copes with change and uncertainty; responds and "shifts gears" comfortably
• Dedicated to meeting the expectations and requirements of both external and internal customers, acts with customers in mind
• Demonstrate ability to establish and maintain effective relationships with customers, and gain their trust and respect
• Utilize logical methods to solve problems with effective solutions; looks beyond the obvious for solutions
• Must be action oriented and sees challenges as opportunities

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Background checks/drug-free workplace.
EOE.

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