Quality Assurance Specialist - Care Alliance

Mission Statement:

Our mission is to provide high-quality, comprehensive medical and dental care, patient advocacy and related services to people who need them most, regardless of their ability to pay. Caregivers demonstrate an elevated level of empathy, compassion and profound respect while providing excellence of care to our patients. They serve as advocates for all in our Northeast Ohio community, especially the most vulnerable.

Job Summary:

The Quality Assurance Specialist is responsible for assisting in the coordination of Care Alliance Health Center (CAHC's) quality initiatives, with a focus on provider credentialing, patient safety, patient experience, and quality improvement measures, metrics and strategies that will enhance patient care. Coordinate proactive implementations of strategies that reduce organization risk in consultation with the Director of Quality and Risk Management. Responsible for maintaining and reporting the quality measures and data instituted by grantors and other CAHC (Care Alliance Health Center) partner and collaborative organizations.

Task Responsibilities:

*Include but are not limited to:

• Utilize EPIC, Azara, UDS, ODM, HRSA and other databases to identify and formulate data relating to the needs of patients and clinical programs, as well abstract data to ensure the alignment of cost with care outcomes

• Manage all aspects of the credentialing, re-credentialing and contract enrolling for all providers. Maintain up-to-date data for each provider in credentialing databases; ensure timely renewal of licenses and certifications.

• Manage patient data and generate reports for analysis for identification of quality-of-care gaps/opportunities.

• Works with the QA Director to identify and report outlying metrics to review with the leadership team.

• Review payor program metrics and formulate the data required to meet CAHC quality initiatives, and participate in monitoring improvement initiatives

• Monitor payor care management program targets and ensure we are on track through monthly monitoring and reporting,

• Work collaboratively with the Director of Quality and risk Management to implement any quality initiatives including population health initiatives.

• Monitor, review, and capture quality initiatives and gaps, and work with Finance department to identify payor incentives.

• Maintain a quality dashboard for tracking and reporting purposes. Creating reports and metrics data for all CAHC departments.

• Other duties as assigned

Minimum Education and Experience: Required:

• Bachelor's degree in Public Health, Epidemiology, Nursing, or a related field, a combination of education and experience may be considered in lieu of formal credentials
• Minimum 3 years of experience developing and implementing health care quality initiatives and data management
• Minimum of 3 years of experience generating quality reports, analyzing data, and reviewing clinical workflows
• Must be proficient in managing insurance payor programs
• Proficient in data abstraction and following metric trends. Experience using EPIC EMR,, Azara and Business Objects preferred
• Strong attention to detail ability to prioritize and multitask.

Compensation details: 60000-65000 Yearly Salary

PIde606799a307-31181-35581031