Job Information

Providence Performance Improvement Coordinator - Quality Revenue Enhancement in Anaheim, California

Description

Under the supervision of the QI Special Programs’ Manager/Supervisor, the Quality Improvement Coordinator will be accountable for the daily duties related to achieving deliverables for health plan Quality Incentive Programs across California. The Quality Improvement Coordinator will be responsible for supporting quality management efforts including development, implementation, education, data collection and analysis.

Essential Functions:

  • Responsible for fully understanding IHA, HEDIS and assigned health plan specific quality measures

  • Responsible for maintaining health plan trackers (e.g., week over week, month over month, year over year)

  • Assess performance results to identify opportunities and trends that drive strategies, interventions, and outreach efforts

  • Collaborate with Special Programs Supervisor and Project Manager, internal teams, and health plans to develop strategies, identify and resolve issues / barriers.

  • Responsible for data mining across all measures, across all health plans and capturing data to close care gaps and improve compliance.

  • Enters data as outside services into Cozeva to improve compliance and close care gaps.

  • Assists with data validation (EMR, health plan, Cozeva) to ensure data is aligned and identify opportunities to submit supplemental data to health plans.

  • Participates in the preparation of and in health plan audits (e.g., IHA, MSSP, PSV).

  • Assists in program design, implementation, and maintenance of a comprehensive quality improvement program across health plans and related programs.

  • Assists in educating new caregivers about QI programs, quality measures and compliance requirements.

  • Partners with internal and external audience on regional outreach campaigns and interventions.

  • Meets with internal and external audience to identify and problem solve QI issues, if any.

  • Monitors medical group and affiliated physicians practice efforts to ensure care gaps are addressed and workflows are followed.

  • Review individual provider performance and provide information on low performing providers to QIS.

  • Prepare slide decks, graphs, data for meetings and reporting purposes.

  • Assist coworkers within our department and other departments with projects and tasks as needed.

  • Follow up on actions required, respond in a timely manner, meet scheduled deadlines, create and implement contingent plans as needed.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required qualifications:

  • 1 year of Experience in a health care setting or medical claims/insurance operations.

Preferred qualifications:

  • PMI Project Management Professional certification upon hire.

  • 5 years of Experience in a health care or managed care system.

  • Project management experience in an ambulatory care environment.

  • Experience with Six Sigma Quality Improvement and Lean Production/Manufacturing processes and tools.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.

About the Team

Providence Physician Enterprise (PE) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.

PE is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 284165
Company: Providence Jobs
Job Category: Process Improvements
Job Function: Quality/Process Improvements
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 7520 QUALITY REVENUE ENHANCEMENT ACO MIPS P4P CA HERITAGE SERVICES
Address: CA Anaheim 200 W Center St Promenade
Work Location: St Joseph Home Health-Anaheim
Pay Range: $27.38 - $42.71
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.