Key Facts

Remote From:

Florida (USA)

Category: Quality Assurance Specialist

Full time

Mid-level (2-5 years)

Spanish, English

Hard Skills

Care Coordination Electronic Health Record Applications Auditing Patient Education And Counseling Patient Education And Counseling Quality Assessment Project Coordination Hospital Experience Cross-Functional Collaboration Patient Monitoring +1 more

Other Skills

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Computer Literacy
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Verbal Communication Skills
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Teamwork
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Problem Solving

Roles & Responsibilities

Current Florida LPN License, active and in good standing (preferred)
One year minimum experience in Clinical Care Coordination
One year minimum experience with an EHR
One year experience in Quality and/or HEDIS

Requirements:

Plan and coordinate care with patients, families, providers, payers, and community resources to maximize outcomes and cost-effectiveness
Facilitate communication among the healthcare team and involve the patient in decision-making to minimize fragmentation; educate on treatment options and resources
Conduct chart audits, participate in quality improvement activities, and support initiatives related to quality metrics and HEDIS; assist in closing care gaps
Support safe transitions of care, promote patient self-advocacy, and engage in payer communications and assigned quality projects; perform other duties as assigned

True Health

About True Health

True Health, a private, non-profit 501 (c)(3) community health center, has been serving low-income, uninsured, underinsured, and underserved populations in Central Florida since 1977. We operate nine service delivery locations within Orange and Seminole Counties, which includes nine neighborhood health centers and two mobile units. True Health was awarded Medical Home accreditation status in October 2012 through the Accreditation Association for Ambulatory Health Care (AAAHC). We are dedicated to providing high quality, comprehensive primary medical, dental, and behavioral health care at a reasonable cost to patients of all ages. As a Federally Qualified Health Center, we offer a sliding fee scale to those that are uninsured, we accept Medicare and Medicaid, and over 25 major health and HMO insurance plans. Annually we proudly serve over 40,000 unduplicated patients with over 101,000 encounters. Services include adult and pediatric family practice, obstetrics and gynecology, dentistry, podiatry, pharmacy, laboratory, and X-ray services.

Founded: 2018

Company size: 201 - 500

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Job description

JOB SUMMARY

The Quality Specialist II helps to ensure True Health provides the highest quality of services to their patients. This position addresses basic and complex support needs of the individual patient and assists in coordination of the therapeutic aspects of the services provided. This coordination will close care gaps for patients through education, monitoring, and advocating for individuals in conjunction with direct care providers.

PRIMARY FUNCTIONS

Plan with the patient, family/caregiver, primary care provider, support staff, payers, and the community resources, to maximize healthcare responses, quality, and cost-effective outcomes.
Facilitate communication and coordination between members of the healthcare team, involve the patient in the decision-making process to minimize fragmentation in the services.
Educate the patient, family or caregiver, and members of the healthcare delivery team about treatment options, community resources, psychosocial concerns, care coordination, etc., so that timely and informed decisions can be made.
Empower the patient to problem-solve by exploring options of care, when available, and alternative plans, when necessary, to achieve desired outcomes.

Encourage the appropriate use of healthcare services and strive to improve quality of care and maintain cost effectiveness on a case-by-case basis.
Assist the patient in the safe transitioning of care to the next most appropriate level.
Strive to promote patient self-advocacy and self-determination.
Attending monthly meetings with insurance payers to have a consistent line of communication open and assist with setting goals for quality improvement.
Work on projects as assigned based on priorities received from insurance companies and internal quality metrics.
Stay involved and active with quality improvement activities.
Conduct chart audits to determine quality compliance and documentation opportunities
Proficient in clinical knowledge to aid other non-clinical colleagues with closing care gaps as needed.
This is a remote position
Other projects/duties as assigned

EDUCATION AND EXPERIENCE

Current Florida LPN License, active and in good standing, preferred
Certified Medical Assistant active and in good standing, considered

KNOWLEDGE, SKILLS, AND ABILITIES

One (1) year minimum experience in Clinical Care Coordination
One (1) year minimum experience with an EHR
One (1) year experience in Quality &/or HEDIS
Expierence working in the clinical environment such as provider office
Computer competency is required

ADDITIONAL QUALIFICATIONS

Bilingual is a plus (English/Spanish)
Must be a collaborator but able to work independently
Excellent spoken and written communications skills
Must have reliable transportation

RELATIONSHIP REPORTING

Reports to Quality Manager

PHYSICAL REQUIREMENTS

Ability to view a computer screen for extended periods of time
Ability to perform repetitive hand and wrist motions for extended periods of time
Ability to communicate effectively with patients and staff

Ability to sit, stand, walk, or view computer screen for extended periods of time
Ability to use hands and fingers to handle or feel
Ability to reach with hands or arms
Ability to perform repetitive hand or wrist motions for extended periods of time
Ability to effectively talk and listen to patients and co-workers