Coordinator-Clinical Quality Administration

American Specialty Health Incorporated (ASH) is seeking a Coordinator to join our Clinical Quality Administration department.

The primary purpose of this position is to coordinate and support the processes within the Clinical Quality Administration Department, including: provide support to department leadership by ensuring accurate documentation preparation and follow-up; assist with completion of clinical quality initiatives; support with administrative tasks related to actions assigned by various committees and teams. Coordinate other assigned functions within Clinical Quality Administration.

Hourly Salary Range

American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $17.84 to $20.00 Hourly Wage Range.

Remote Worker Guidelines

• Remote Worker Guidelines: This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet connection must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher quality video meetings.

Responsibilities

• The work will consist of the following activities:
  • Assists in management and is accountable for all activities within assigned scope of authority. Ensures accuracy and productivity in project completion and works cooperatively with all internal and external contacts. Achieves and exceeds company standards.
  • Ensures confidentiality of documentation and clinical meeting materials according to ASH policy.
  • Assists with development of quarterly Clinical Performance Management (CPM) and California Health Plan Assessment (CAHPA) reports.
  • Provides administrative support with management of annual review of ASH Group and ASH Plans clinical policies through the Clinical Quality Team.
  • Aids in continuous annual review process for all Clinical Services Process and Procedure documents.
  • Supports Clinical Quality Administration budgeting and preparation of the Practice Review Committee (PRC), Quality Improvement Committee (QIC), Administrative Review Committee (ARC) and Provider Hearing stipends following each meeting.
  • Supports the Clinical Quality Administration processes that ensure the integrity and accuracy of documents created and distributed by the department.
  • Provides committee support for the Medicare Advantage Utilization Management Committee (MA-UMC):
    • Performs administrative support related to meeting coordination among internal staff and external consultants. meeting preparation, and recording committee minutes.
    • Develops, tracks, and distributes documents in support of committee processes and according to policy.
  • Provides committee support for the Practice Review Committee (PRC):
    • Performs administrative tasks related to preparation of files for presentation to clinical committees (copying, redacting, etc.)
    • Develops, tracks, and distributes documents in support of committee processes and according to policy.
    • Supports development and timely completion of activities requested by clinical committees (e.g., letters, reports, research, follow-up, etc.).
    • Ensures timely completion of action items as assigned.
  • Assist with Clinical Services Investigation Team (CSIT) Administrative Activities:
    • Prepare, send, and log CSIT educational letters.
    • Assist in preparation of CSIT reports.
    • Perform administrative tasks related to preparation of files for presentation to clinical committees (copying, redacting, etc.).
    • Perform other administrative tasks that may arise related to CSIT functions.
  • Cross-trained in committee support functions for Clinical Quality Team (CQT), Practice Review Committee (PRC) and Quality Improvement Committee (QIC).

  Other duties:

  • Support CQA management with quality improvement initiatives, policy documentation, reporting requirements, and project management.
  • Prepare standardized, department and individual reports as needed.
  • Assist department leadership by researching, developing and creating processes necessary to support projects.
  • Develop and report information from tracking systems.
  • Write, track and mail or distribute documents as directed by department leadership in support of Clinical Quality Administration activities.
  • Assist with special projects as required.
  • Support accreditation and delegation efforts on behalf of Clinical Quality Administration.
  • Contribute to team effort by responding positively to changing circumstances and/or environment.
  • Supports mail receipt and mail distribution to CQA, CQE and MNA.
  • Supports quality management functions of other administrative departments to ensure efficient and effective teamwork is maintained within the organization.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• College education with degree in Healthcare field, health information management, or equivalent experience preferred. If equivalent experience, High School Diploma required.
• 2 years experience in health care administrative work preferred.
• Committee support including minute taking experience highly preferred.
• Quality Management program coordination and support of documentation for provider-based Committees and experience in data management preferred.
• Knowledge of health care and/or legal terminology preferred. (Medium proficiency)
• Use of computer required. (High proficiency)
• Proficiency with Microsoft Word and Excel required. (High proficiency)
• Knowledge of ASH preferred. (Low proficiency)
• Great attention to detail is required in all functions of this position. (High proficiency)
• Working knowledge of HIPAA, NCQA, and URAC standards preferred. (Low proficiency)
• Demonstrated English writing proficiency required. (High proficiency)

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

• Primarily sedentary, able to sit for long periods of time.

Physical Requirements

• Ability to see, speak, and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within and around the facility or Work from Home (WFH) environment. Capable of using a telephone, computer keyboard, and mouse. Ability to lift up to 10 lbs.

Environmental Conditions

• Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth, related medical conditions, breastfeeding, and reproductive health decision-making), gender, gender identity, gender expression, race, color, religion (including religious dress and grooming practices), creed, national origin, citizenship, ancestry, physical or mental disability, legally-protected medical condition, marital status, age, sexual orientation, genetic information, military or veteran status, political affiliation, or any other basis protected by applicable local, federal or state law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

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Originally posted on Himalayas