Overall Purpose The Regional Quality Coordinator role is responsible of managing Quality operational support initiatives while overseeing special projects, with a focus on supporting HEDIS and Pharmacy gap closures. This…
Skills: HEDIS, Quality Management, Data Mining, Medication Adherence, Project Management
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Skills: HEDIS, Quality Management, Data Mining, Medication Adherence, Project Management
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$22/hr–$28/hr
Full-time
high school, associate degree
Posted 3d ago
~40 hrs/week
Responsibilities
The Regional Quality Coordinator manages quality operational support initiatives, including HEDIS and pharmacy gap closures, while coordinating across departments to meet performance goals. This role involves direct patient outreach, data collection through medical records, and providing quality performance reporting to affiliate groups.
Requirements
Candidates must have at least two years of healthcare-related experience and proficiency with Electronic Health Records and Microsoft Office. A high school diploma or GED is required, with an associate degree and clinical certifications like Medical Assistant or Pharmacy Tech preferred.
Full job description
Overall Purpose
The Regional Quality Coordinator role is responsible of managing Quality operational support initiatives while overseeing special projects, with a focus on supporting HEDIS and Pharmacy gap closures. This position requires daily problem-solving, meticulous tracking, and coordination across departments to meet varying and changing requirements. The RQC will oversee assigned affiliate groups, providing Quality operational support to clinics to achieve their goals, which may include engaging with internal and external stakeholders with in-person and telephonic outreach to patients for education and engagement on preventative screenings, data mining, medication adherence, and follow-up with primary care providers. This position may directly interact with patients to complete tasks for quality gap closure.
The Regional Quality Coordinator will support the assigned market under the direction of the market VP with the assistance of the National Quality Manager.
Essential Functions
Understands the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards, CAHPS, HOS, and HIPAA
Provides support to the Quality Management Department by working with members and network providers to improve quality of care through quality activities such as HEDIS, CMS Star Rating, and other quality performance reporting
Provides telephonic outreach to patients, providers, and pharmacies to discuss opportunities for optimizing medication use or other opportunities for improvement of healthcare performance measure related issues
Improves patient experience and transitions for better healthcare outcomes through quality care
Participates in data collecting through medical record and claims surveillance
Works to maximize health plan and healthcare provider performance on healthcare related quality measures through effective telehealth communication with patients and coordination with patient caregivers, providers, and pharmacies.
Assists in planning, implementing, and executing projects to improve quality and delivery of care services
Using research and knowledge, identifies potential interventions to improve quality strategies
Participates in Quality Management meetings and other initiatives
Prepares quality information for presentation to affiliate groups, including groups current standings relative to others and opportunities or improvement
Point of Contact for provider groups designated by leader
Leads project management of Quality Fairs, Diabetic Days, and P3 events to maximize quality gap closure
Subject Matter Expert in P3 machines (diabetic eye camera, bone density machine, etc.)
Responds to health plan, provider and interdepartmental calls in accordance with exceptional customer service
Reviews provider group gap uploads through the P3 Provider portal
Other duties as assigned
Education and Experience
High school diploma/GED required, associate degree in related field or equivalent experience preferred.
2+ years experience in healthcare-related fields required, clinical health care related experience, managed care, or Health plan experience strongly preferred.
Experience with Microsoft Word, Excel, Power Point, Outlook and general office equipment such as copier, fax machine, required.
Experience in Electronic Health Records required.
Medical Assistant Certification or experience as a Pharmacy Tech, Radiology Tech, Lab Tech or similar strongly preferred.
Experience with data mining is preferred.
Medical terminology knowledge required, experience with CPT II codes preferred.
Work Conditions
Availability to travel within assigned region and work from multiple providers offices as needed.
Must have a valid driver’s license, safe driving record, and able to furnish reliable transportation.
Work Location & Schedule
This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
Pay range per hour: $22 - $28 based on experience
About P3
People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.
We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.
We are looking for a Regional Quality Coordinator. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.
Related keywords
HEDISQuality ManagementCMS Star RatingNCQAHIPAACAHPSHOSData MiningElectronic Health RecordsMedication AdherenceProject ManagementMedical AssistantPharmacy TechRadiology TechLab TechCPT II Codes
A population health company led by physicians and driven by people with passion and purpose.
Industry
Hospitals and Health Care
Company size
201-500 employees
Founded
2015
Headquarters
Henderson, Nevada
LinkedIn followers
7,802
Total funding
$332M
At P3 Health Partners (PIII) we’re redefining healthcare by putting people at the center of everything we do. As a physician-led, patient focused organization we are committed to delivering value based care that improves outcomes and supports healthier communities.
Our mission is simple: fix what’s broken in healthcare. We’re working to reduce provider burnout, restore purpose in clinical care and ensure patients receive the right care at the right time before health issues become emergencies.
Together we’re building a system that prioritizes prevention, compassion and meaningful change.
Offices: 2370 Corporate Circle, Suite 300, Henderson, Nevada 89074, US · 5255 E Williams Circle, Ste. 300, Tucson, Arizona 85711, US · 2525 12th St. SE, Ste. 240/250, Salem, OR 97302, US · 5425 Park St N, Suite 7W, St Petersburg, Florida 33709, US · 2370 Corporate Circle, Suite 200, Henderson, Nevada 89074, US
Healthcare TransformationFinanceHospitalHealth CareMedical DeviceFinancial ServicesVenture Capital
A population health company led by physicians and driven by people with passion and purpose.
Industry
Hospitals and Health Care
Company size
201-500 employees
Founded
2015
Headquarters
Henderson, Nevada
LinkedIn followers
7,802
Total funding
$332M
At P3 Health Partners (PIII) we’re redefining healthcare by putting people at the center of everything we do. As a physician-led, patient focused organization we are committed to delivering value based care that improves outcomes and supports healthier communities.
Our mission is simple: fix what’s broken in healthcare. We’re working to reduce provider burnout, restore purpose in clinical care and ensure patients receive the right care at the right time before health issues become emergencies.
Together we’re building a system that prioritizes prevention, compassion and meaningful change.
Offices: 2370 Corporate Circle, Suite 300, Henderson, Nevada 89074, US · 5255 E Williams Circle, Ste. 300, Tucson, Arizona 85711, US · 2525 12th St. SE, Ste. 240/250, Salem, OR 97302, US · 5425 Park St N, Suite 7W, St Petersburg, Florida 33709, US · 2370 Corporate Circle, Suite 200, Henderson, Nevada 89074, US
Healthcare TransformationFinanceHospitalHealth CareMedical DeviceFinancial ServicesVenture Capital