Under the general direction of the Quality Director or Accreditation Director, this position is responsible for helping to plan, organize, and implement Alliance Quality programs.
Principal responsibilities include:
· Facilitate quality initiatives and programs, including member outreach, provider outreach and interdepartmental communications.
· Maintain resource directory of network and delegate provider and office staff contact information and hours of operation in order to provide best geographic, resource, and physical accessibility information.
· Conduct reminder calls and reminder mailings to members or providers targeted in Quality initiatives or programs.
· Coordinate Quality projects.
· Conduct follow-up to members who have participated in Quality programs to determine program effectiveness.
· Represent the Alliance at community meetings and events.
· Create and run periodic departmental reports.
· Maintain departmental worksheets or limited data sets.
· Assist with development of Quality Department materials.
· Assist with review, tracking, and annotating of medical records, program policies, reports and materials.
· Coordinate collection of medical records, including but not limited to: copying, printing, and coordination with the mail house/mail room.
· Arrange logistics for Quality projects including scheduling medical record review and medical record collection. Complete other duties and special projects as assigned.
ESSENTIAL FUNCTIONS OF THE JOB
· Telephone contact with members and providers, providing assistance in accessing Health Education services.
· Coordinate logistics for Quality programs.
· Assist with development, implementation, and evaluation of programs.
· Attend meetings with other department staff to identify on-going concerns and lessons learned for future outreach programs.
· Assist with development and production of Quality department materials.
· Contact with community providers and organizations.
· Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
· Constant and close visual work at desk or computer.
· Constant sitting and working at desk.
· Constant data entry using keyboard and/or mouse.
· Frequent use of telephone headset.
· Constant verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
· Frequent lifting of folders and other objects weighing between 0 and 30 lbs.
· Frequent walking and standing.
· Occasional driving of automobiles.
EDUCATION OR TRAINING EQUIVALENT TO:
· Bachelor’s degree or equivalent work experience required. Academic major in health services or related field preferred.
SUBSTITUTION FOR ACADEMIC MAJOR:
· Year over year full time experience may be substituted for the academic major (up to 4 years) when administrative duties are performed in a health service agency or program.
· Minimum one year managed care experience preferred.
SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):
· Proficiency in correct English usage, grammar, and punctuation required.
· Excellent problem solving skills.
· Ability to manage multiple tasks simultaneously.
· Ability to work with members in a professional, respectful and responsive manner.
· Ability to work with diverse groups including low-income populations and health care providers.
· Knowledge of Medi-Cal desirable.
· Knowledge of Alameda County communities desirable.
· Ability to maintain cooperative relations with community and professional groups.
· Ability to communicate effectively, both verbally and in writing.
· Must be organized, detail oriented, and have the ability to work in cooperation with others.
· Strongly proficient in Microsoft Word, Excel and Adobe Acrobat Pro preferred.
· Possession of valid California driver’s license and proof of California auto liability are required.