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Corporate Functions & Operations WellCare - Quality Improvement Careers

Quality Improvement Coordinator - Senior Job

Full Job Title: Quality Improvement Coordinator, Sr.

Job Number: 1706017

Location: Oahu, HI

Date Posted: 12-13-2017

Provides support and project coordination for the field quality improvement team. Responsibilities include establishing working relations with both corporate partners and field Quality Improvement (QI) staff as well as Medical Directors across all Medicare markets.

Essential Functions:
  • Provides support for the field Quality Improvement team across 12 Medicare states with potential for increased coverage as the line of business expands.
  • Completes special projects or assignments as needed to meet initiatives and/or objectives of department.
  • Assists and coordinates QI projects as needed.
  • Maintains all department files in an organized, accurate manner.
  • Assists with preparations for meetings by typing agendas, attachments and minutes; develops and revises PowerPoint presentations; maintains participant rosters; distributes documents via SharePoint, creates hard copy binder for committee chair and file room.
  • Required to travel to corporate office for Quality Improvement committee meetings and other Medicare related meetings as deemed necessary.
  • Maintains supply levels, equipment maintenance, communications and records.
  • Maintains and secures files of QI activities.
  • Directs communication to the appropriate staff.
  • Responsible for managing the non-clinical portion of Quality of Care Issues (PQOCS); tracking/trending database, reports issues as directed to the credentialing department, obtains medical records, maintains PHI as per policy, tracks correspondence to/from providers.
  • Responsible for managing the Medicare ambulatory medical record review process; maintains database of providers review, data enters outcome of review, and tracks correspondence related to Corrective Action Plans (CAPs).
  • Other duties: ability to adapt to changes in policies/procedures and circumstances, learn new techniques, and accept additional responsibilities as assigned.
  • High school diploma is required
  • College degree in a health related field is preferred
  • 3-5 years of experience in a managed care health services environment
  • Knowledge of medical terminology
  • Experience in data collection and data entry is required
  • Understanding of data analysis and continuous quality improvement process is preferred
  • Understanding/application of project management principles is preferred

Special Skills (e.g. 2nd language):
  • Excellent communication skills
  • Ability to communicate effectively with people at all levels
  • Ability to arrange their own work day
  • Ability to multitask in a fast paced environment
Technical Skills/Requirements:
  • Proficient in Microsoft Office including MS Word, MS Excel, MS Access, MS PowerPoint and MS Outlook *LI-RG1

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Last Updated On: 12/9/2015