Quality Specialist

Posted Yesterday
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Hialeah, FL, USA
In-Office
Junior
Healthtech
The Role
Supports the Wellness and Preventive Management Program by abstracting clinical data for HEDIS reporting, identifying quality gaps, reviewing noncompliant records, coordinating documentation, monitoring provider and group performance, and collaborating with primary care teams to improve quality measures and close care gaps.
Summary Generated by Built In

As Mount Sinai grows, so does our legacy in high-quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Department:

Job Description Summary:

Position Responsibilities
  • Responsible for supporting the Wellness & Preventative Management Program (WPM): HEDIS, Annual Wellness Visits, Appointments, and other Care Coordination tasks.
  • Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting, e.g. results of laboratory tests, verification of hypertension and the most recent blood pressure reading.
  • Collect medical record data and identify needed improvements that impact HEDIS measures.
  • Review noncompliant reports and flags patient’s charts with the missing measures.
  • Request quality data documentation from outside resources.
  • Works closely with leadership to execute quality strategies.
  • Manage the reports and monitors performance at group and providers level.
  • Engages PCP and clinic staff in developing strategies to close quality gaps.
  • Upload HEDIS data to medical records and send it to the health plan.
  • Performs all other related duties as assigned
Qualifications
  • License/Registration/Certification
    • Preferred Certified Medical Assistant or Registered Medical Assistant.
  • Education
    • Required: High School Diploma. Preferred: Bachelor of Sciences degree or in other related field, foreign medical graduate
  • Experience
    • Preferred: One year of experience in Care Coordination in outpatient setting or HMO, MSO or ACO.

Benefits:

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:

  • Health benefits
  • Life insurance
  • Long-term disability coverage
  • Healthcare spending accounts
  • Retirement plan
  • Paid time off
  • Pet Insurance
  • Tuition reimbursement
  • Employee assistance program
  • Wellness program
  • On-site housing for select positions and more!

Degree Requirements:

Certification:

Skills Required

  • High school diploma
  • Certified Medical Assistant or Registered Medical Assistant certification
  • Bachelor of Science degree or related field
  • Foreign medical graduate background
  • One year of care coordination experience in an outpatient setting, HMO, MSO, or ACO
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The Company
4,000 Employees
Year Founded: 1949

What We Do

Mount Sinai Medical Center is a private, independent, not-for-profit teaching hospital serving South Florida. Established in 1949, it provides advanced medical care through 12 facilities and 38 services, including cancer, emergency, orthopedic, and cardiovascular care. Its mission emphasizes excellent healthcare for a diverse community through clinical expertise, innovation, education, research, charity care, and financial responsibility, while training the next generation of healthcare professionals.

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