Salary Range: $62,166 - $93,250
The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.

FLSA Status:Non-Exempt
Department:Quality Improvement
Reports To: Manager, Clinical Quality & Safety (RN)

Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521

The Quality Improvement (QI) Coordinator provides support for QI activities and programs to contribute to the effectiveness and efficiency of the department. The QI Coordinator will assist departmental programs and initiatives such as Process Improvement, Cultural and Linguistics, NCQA, Health Homes and Health Education.

To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.

1. Provide project coordination and administrative support for NCQA and Process Improvement activities.
2. Support the Health Homes Program by coordinating meetings, documenting workflows, maintaining meeting minutes, creating and reviewing reports, and providing other operational assistance as needed.
3. Coordinate Facility Site Review (FSR) and Potential Quality of Care Issue (PQI) processes, including providing lists of members to Site Review Nurse.
4. Track and input data into FSR and PQI database, generate PQI and FSR reports for the quality and organizational dashboard and organize and file paperwork related to cases.
5. Respond to member, provider and SCFHP staff inquiries regarding health education resources and SCFHP and member eligibility and billing from health education vendors.
6. Generate reports and documents as needed; assist in documenting and developing procedures.
7. Coordinate health education and other quality programs, including the scheduling of meetings with community partners, preparing of packets for member and provider outreach, and the documenting of information into the care management platform.
8. Assist with the coordination of the Cultural and Linguistics Program for utilization of services by members.
9. Track language translation requests to ensure compliance timeframes are being met.
10. Provide support and represent the QI department at internal and external meetings and follow-up on QI department action items to ensure deliverables are met.
11. Conduct on-site provider visits to provide training on health education resources and deliver member gaps in care lists.
12. Implement and maintain Initial Health Assessment (IHA) Work Plan, including coordinating medical record audits of IHA visits, updating of the SCFHP website to ensure current IHA requirements are posted, and reporting of IHA rates.
13. Contribute to annual HEDIS project through data analysis for review by the HEDIS project manager.
14. Perform other related duties as required or assigned.

The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.

1. Bachelor's Degree in Health Sciences, Public Health, or Health Care or related field, or equivalent experience, training or coursework. (R)
2. Minimum one year of experience working in a healthcare setting supporting QI and/or other related healthcare programs.(R)
3. Prior experience with managed care plans, Medi-Cal and Medicare programs, and working with underserved populations. (D)
4. Ability to pay attention to detail and work accurately. (R)
5. Ability to form positive, professional relationships with internal and external stakeholders. (R)
6. Ability to analyze data. (R)
7. Critical thinking with the ability to look for gaps and ensure contractual requirements are being met by department programs. (R)
8. Possess and maintain a valid, current California Driver's License. (R)
9. Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications, such as Outlook, Word and Excel. (R)
10. Ability to use a keyboard with moderate speed and a high level of accuracy. (R)
11. Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP members and providers over the telephone, in person or in writing. (R)
12. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
13. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R)
14. Ability to maintain confidentiality. (R)
15. Ability to comply with all SCFHP policies and procedures. (R)
16. Ability to perform the job safely with respect to others, to property, and to individual safety. (R)

Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.

Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:

1. Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
2. Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
3. Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
4. Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
5. Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
6. Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday

General office conditions. May be exposed to moderate noise levels.

EOE