Clinical Quality Improvement Coordinator

About the role

The Clinical Quality Improvement Coordinator at Guide Health is tasked with conducting scheduled diabetic eye exams (retinal screenings) for patients at various provider practices and in their homes. Utilizing specialized imaging equipment provided by the company, this role also supports quality improvement initiatives across multiple healthcare programs. On days without scheduled appointments, the coordinator will engage in activities such as quality reporting, patient outreach, and data abstraction to enhance healthcare delivery and outcomes.

Key facts

What you'll do

• Travel extensively within the Nashville area to perform diabetic eye exams at provider locations and patient residences, ensuring high-quality care and service delivery.
• Act as a knowledgeable resource for quality measures related to Medicare Advantage STAR, Commercial, Medicaid, and MSSP ACO programs, contributing to various quality improvement efforts.
• Conduct diabetic eye exams using company-provided retinal imaging equipment, completing necessary training to ensure proficiency and compliance with procedures.
• Engage in proactive patient outreach on non-appointment days to identify quality gaps and encourage adherence to preventive care measures.
• Educate patients about the importance of regular screenings and assist them in scheduling necessary follow-up appointments to enhance health outcomes.
• Manage a daily schedule for eye exams, confirming appointments with both patients and practices while coordinating travel logistics, with all travel expenses covered by the company.
• Support quality reporting and performance improvement initiatives, ensuring compliance with MSSP reporting requirements and other payer-specific submissions.
• Collect and analyze quality data from various sources, including EMR systems, claims data, and patient engagement workflows, to identify trends and areas for improvement.
• Utilize multiple systems and applications, including Microsoft 365, to manage daily tasks and maintain effective communication with team members and stakeholders.
• Collaborate with internal teams, customers, providers, and payers to communicate quality performance trends and develop strategies for improvement.
• Participate in ongoing training and development opportunities to enhance skills and knowledge related to quality improvement and healthcare standards.
• Build and maintain strong relationships with co-workers, patients, and healthcare partners to foster a collaborative environment focused on quality care.

Requirements

• Must be willing and able to travel daily, up to 100%, to perform scheduled eye exams; no prior experience with eye exams is necessary, as comprehensive training will be provided.
• A valid driver's license and reliable transportation are required for this position.
• An associate degree or higher in a relevant field is preferred.
• At least 1-3 years of experience in a healthcare environment is necessary.
• A minimum of 2 years of experience with Medicare Advantage, Commercial, Medicaid, or MSSP quality programs, particularly in data abstraction and patient outreach, is essential.
• Familiarity with EMR systems, medical records, and health data management is crucial for success in this role.
• Knowledge of medical terminology, quality measures, and coding practices is advantageous.
• Proficiency in Microsoft Office Suite, including Excel, PowerPoint, Word, and Teams, as well as various healthcare-related applications, is required.
• Strong verbal and written communication skills, along with exceptional attention to detail and organizational abilities, are essential for managing tasks effectively.
• The ability to work independently and collaboratively in a dynamic environment is important for this role.

Nice to have

• Certification or licensure as a healthcare professional, such as a Certified Medical Assistant (CMA) or Licensed Practical Nurse (LPN), is a plus.
• Experience with quality improvement initiatives and data submissions for health insurance payers is beneficial.
• Familiarity with Medicare Advantage STAR, Medicaid, Commercial, and MSSP ACO quality programs will be advantageous.
• Knowledge of NCQA/HEDIS®, CMS, and payer-specific quality measure specifications is preferred.
• Experience with quality database entry and performance reporting is a valuable asset.
• Previous experience in training staff or educating care teams on quality initiatives is a plus.

Skills & tools

• Proficient in using Electronic Medical Record (EMR) software, payer portals, and cloud-based applications.
• Strong analytical skills to interpret and report on quality data effectively.
• Excellent organizational skills to prioritize tasks and meet deadlines consistently.
• Strong interpersonal skills to foster collaboration among various stakeholders in the healthcare ecosystem.

Practical notes

• The salary for this position ranges from $60,000 to $64,000 annually.
• Candidates must reside in the Nashville area to be eligible for this position.
• All travel expenses related to patient appointments will be reimbursed by the company.
• Ongoing training and professional development opportunities will be provided to ensure staff remain knowledgeable about industry standards and practices.

At Guide Health, we are committed to fostering a culture that thrives on purpose and collaboration, ensuring that our values are reflected in every aspect of our work. Join us in making a difference in the healthcare landscape!