InnovaCare Services Company, LLC
InnovaCare Health is a dynamic physician lead healthcare provider pioneering change in value-based healthcare. We operate 40+ clinics with 1,100+ employees who share the mission, vision, and values that drive success in each of the communities we touch. Our goal isn’t just healthcare; it’s about promoting work-life balance and supporting the personal and professional goals of each employee to help them lead their best lives.
We are an organization strengthened by our diversity and inclusion. We strive to make an impact in the community through public health education, outreach, and our philanthropic endeavors that span beyond the doors of our facilities.
As we continue to grow, we want employees, like you, who value improving the lives of those they care for each day. #WeAreInnovaCare
Our practices offer: Women’s Health, Wellness, X-Ray/Ultrasound, Dental, Chiropractic, Urgent Care, Managed Care, and Workers Comp services
Job Summary
General responsibilities of a quality coordinator are to provide quality support of the clinic team and patients; ensure medical records remain up to date; and the clinic meets regulatory and quality record standards and resolves any issues or discrepancies as they arise.
In this role, the coordinator will be expected to perform audits on all medical records and review the data to ensure records are accurate and able to assess the quality of patient care. It is crucial for the Quality Coordinator to have knowledge of CMS stars rating process, Medicaid Quality measures programs and clinical standards and outcomes.
Essential Job Functions
Daily review of and prepare for the next day of assigned provider’s Cap patients.
Daily review of quality in medical records, update records accordingly to aid preparing for the next day patient visits.
Responsible for coordination of care regarding quality gaps measures pending with our office managers and QI director.
Responsible for coordination of any quality gaps measures events with QI director.
Responsible for coordination of quality chart review requests from insurance companies, document, and follow-up with insurance companies.
Responsible to coordinate with clinic administrators regarding medical records from hospitals, specialist visits and/or SNH for office follow-up missing in a chart.
Identify and follow up with errors regarding billing or medical assistant’s documentation detailing quality measures.
Send to QI Director Spreadsheet or similar report on time for process.
Responsible for keep our EHR/EMR system (example, eCW, NextGen) up to date as:
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Identified and correct any patient’s information error.
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Quality Spreadsheet
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CDSS/Alerts
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Quality Global Alerts
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Arcadia Quality Measures Portal.
Minimum Required Education, Experience & Skills
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Must complete at least a two-year associates degree through a technical school or community college.
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Must have completed Medical Assistant certification.
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Two years of EHR/EMR system experience (eCW, Next Gen or similar system experience preferred).
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1-2 years healthcare experience – as a quality coordinator preferred.
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One year Stars Rating/Medicaid quality measures experience.
Preferred Education, Experience & Skills
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Relationship Management skills.
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Effective written/verbal communication.
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Ability to effect or advocate for change.
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Perform critical clinical analysis.
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Plan and organize effectively reports.
Physical & Mental Requirements: (check all that apply)
☐ Required immunizations and vaccinations.
☐ Ability to lift upwards of 50 pounds.
☐ Ability to push or pull heavy objects using up to 100 pounds of force.
☐ Ability to stand or sit for extended periods of time.
☐ Ability to use fine motor skills to operate equipment and/or machinery.
☐ Ability to properly drive and operate a company vehicle.
☐ Ability to receive and comprehend instructions verbally and/or in writing.
☐ Ability to use logical reasoning for simple and complex problem solving.
☐ Occasionally requires exposure to communicable diseases or bodily fluids.
☐ Ability to discriminate shades of color when reading a dipstick.
The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.
What We Do
InnovaCare Health improves the lives of members and physicians through innovative solutions for value-based healthcare. In each unique market the company serves, InnovaCare works across the healthcare ecosystem – with patients, providers, payers and other partners – to increase access to high-quality, affordable care.
Based in White Plains, N.Y., InnovaCare has been on the forefront of value-based care for more than a decade, distributing risk and developing proprietary technologies to inspire patient and provider engagement. Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more than 150,000 dual-eligible beneficiaries. InnovaCare’s Medicare Advantage plans have received NCQA accreditation and 4.5-star quality ratings from the Centers for Medicare and Medicaid Services (CMS).