MINIMUM QUALIFICATIONS:

• Required-High school diploma or equivalent
• Required-2 years of related experience in health care, OR any equivalent combination of experience, training and/or education approved by Human Resources.
• Required-Must maintain current BLS Certificate
• Preferred-Associate’s Degree (two-year college or technical school) in related field
• Preferred-Experience in a Federally Qualified Health Center

SKILLS:

Strong computer and EHR skills, good with data and reports. Detail-oriented, organized, and able to work well both alone and with a team. Great at time management, problem solving, and keeping things confidential. Solid communication and customer service skills across departments

ABOUT THE ROLE:

The Clinical Quality Specialist supports the Clinical Quality Supervisor by reviewing and tracking quality-related data. They help prepare and submit reports for programs, grants, and compliance, while working with patients, providers, and staff to close care gaps and make sure preventive care is on track.

RESPONSIBILITIES:

• Collaborates with health insurance plans to promote quality patient care through quality programs such as P4P, ACO, HEDIS, CMS, etc. Works to remedy care gaps and/or health reminders as defined by payor groups and quality programs
• Collects and delivers supplemental documentation as requested by health insurance plan programs.
• Collaborates with the care team (patient, provider, payor, support staff, etc.) to conduct patient health maintenance. Works with leadership team to develop workflows to close payor care gaps. Coordinates appointment scheduling, protocol screenings, health education, and follow-up as appropriate.