Clinical Quality Improvement Coordinator

About the role

The Clinical Quality Improvement Coordinator at Guide Health plays a vital role in enhancing healthcare quality through the execution of scheduled diabetic eye exams. This position involves traveling to various provider practices and patient residences to conduct retinal screenings using specialized imaging equipment. On days without scheduled appointments, the coordinator will engage in broader quality improvement initiatives across multiple healthcare programs, focusing on quality reporting, performance enhancement, and patient outreach. The ideal candidate will be adept at managing multiple tasks and communicating effectively with various stakeholders.

Key facts

What you'll do

• Conduct scheduled diabetic eye exams (retinal screenings) at provider practices and patient homes, utilizing company-provided imaging equipment.
• Travel extensively within the Houston area to fulfill appointment obligations, ensuring timely and efficient service delivery.
• Serve as a knowledgeable resource on quality measures related to Medicare Advantage STAR, Commercial, Medicaid, and MSSP ACO programs.
• Participate in comprehensive training on retinal imaging equipment and eye exam protocols to ensure high-quality service.
• Engage in proactive outreach to patients on non-appointment days to identify and address quality gaps in healthcare delivery.
• Educate patients about preventive care, assisting them in scheduling necessary screenings and adhering to treatment plans.
• Manage a daily schedule of eye exam appointments, confirming details with patients and practices while coordinating travel logistics.
• Support quality reporting and performance improvement initiatives, including compliance with MSSP and payer-specific requirements.
• Collect and abstract quality data from various sources, including EMR systems, claims data, and medical records.
• Utilize multiple healthcare applications and systems to manage daily tasks and ensure accurate data handling.
• Analyze quality performance trends and communicate findings to internal teams and external stakeholders.
• Collaborate with various departments, customers, and care teams to enhance quality improvement efforts and patient outcomes.
• Participate in training sessions and webinars to stay updated on quality improvement practices and payer requirements.
• Build and maintain strong relationships with co-workers, customers, providers, and care teams to foster a collaborative work environment.
• Take on additional responsibilities as needed to support quality improvement initiatives and patient outreach efforts.

Requirements

• A valid driver's license and reliable transportation for daily travel to appointments.
• An associate degree or higher in a relevant field.
• At least 1-3 years of experience in a healthcare environment.
• A minimum of 2 years of experience with Medicare Advantage, Commercial, Medicaid, or MSSP quality programs, including data abstraction.
• Familiarity with EMR systems, medical records, and health data workflows.
• Understanding of medical terminology, quality measures, and medical billing or coding practices.
• Proficiency in Microsoft Office Suite, including Excel, PowerPoint, Word, Outlook, and Teams.
• Excellent verbal and written communication skills, with a strong emphasis on attention to detail and organizational abilities.
• Capability to work independently while managing multiple deadlines and tasks efficiently.

Nice to have

• Certification or licensure as a healthcare professional, such as a Certified Medical Assistant (CMA) or Licensed Practical Nurse (LPN).
• Experience with quality improvement initiatives and data submissions required by health insurance payers.
• Familiarity with NCQA/HEDIS®, CMS, MSSP, or payer-specific quality measure specifications.
• Background in quality database entry, reporting, and performance dashboard management.
• Experience in training staff or educating providers and care teams on quality initiatives.

Skills & tools

• Proficient in using Electronic Medical Record (EMR) software, payer portals, vendor platforms, and cloud-based applications.
• Strong analytical skills to interpret and report quality information effectively.
• Ability to prioritize tasks and manage time efficiently in a fast-paced environment.

Practical notes

The salary range for this position is between $60,000.00 and $64,000.00 annually. This role requires a commitment to traveling daily within the Houston area to meet patient and provider needs. All travel expenses related to eye exam visits will be covered by the company.

ALIVE with Purpose: How We Thrive at Guide Health

At Guide Health, our core values are integral to our operations and culture. We strive to create an environment where our employees can thrive while making a meaningful impact on healthcare quality and patient outcomes.