Quality Improvement Coordinator

Description

About Us:
Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.

SUMMARY: The Quality Improvement Coordinator will be responsible for coordinating and implementing quality improvement initiatives related to HEDIS measures and risk adjustment/HCC. This individual will work with internal and external stakeholders to ensure compliance with HEDIS specifications, data collection, reporting, and improvement strategies.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• Outreach to providers and retrieve medical records by phone, email, fax, or in-person visit to identify gaps and opportunities for improvement for RAF and HEDIS
• Review and summarize collected data with trend analysis for additional provider educational opportunities.
• Collaborate with internal departments to review and implement projects and interventions to improve delivery of services and quality of care.
• Assist with audits and reviews to ensure data accuracy and validity.
• Attend health plan meetings as requested by department leadership.
• Stay updated on HEDIS and risk adjustment specifications, guidelines, and industry trends.
• Regular and consistent attendance
• Other duties as assigned 

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Free lunches on site

Requirements

EDUATION and/or EXPERIENCE:

• Bachelor’s Degree preferred.
• 2+ years of quality improvement or healthcare related experience.
• Familiarity of HEDIS measures, specifications, and reporting requirements.
• Proficient in data analysis, Excel, and quality improvement methodologies.
• Excellent communication, presentation, and interpersonal skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Detail-oriented, organized, and problem-solving skills.