Myrtle Hilliard Davis Comprehensive Health Centers, Inc
  • 27-Jul-2017 to 25-Jul-2018 (CST)
  • Medical
  • St. Louis, MO, USA
  • Hourly
  • Full Time

Medical, Dental, Vision, 403B, STD/LTD, PTO


Myrtle Hilliard Davis Comprehensive Health Centers, Inc. is seeking a full-time Quality Outcomes Coordinator  will collaborate with the Director of Quality Improvement and the Quality Performance Analyst on utilization review projects including review and abstraction of data from within all software systems (Practice Analytics, DRVS, Intergy) and routine medical record reviews and audits of patient utilization.

 

Duties:

  • Perform comprehensive quality review of clinical documentation ensuring it is consistent and comprehensive; verify that NCQA guidelines are being followed in all documentation.
  • Provide utilization review for members receiving services and collaborate with PCMH and providers to increase performance measures and HEDIS scores.
  • Monitor provider performance through administrative data and medical record review; Identify training needs and trends based on reviews. Assess care opportunities, designing and implementing member and provider specific actions or interventions
  • Performs all aspects of medical record review, HEDIS and Quality Management as needed for completion of Healthcare Quality Assessment Forms (HQPAF).
  • Collaborate with health care team on patient engagement and retention with a focus on Medicare/Medicaid populations to enhance care management and coordination efforts for high risk patients.
  • Participate in Quality Management and Peer Review committees.
  • Demonstrates ability to prioritize, balance time and maintain quality to meet established time frames, deadlines and business needs.
  • Develop strong working relationships with all departments and divisions, physicians, and non-physician providers and other delegated entities.

 

A Successful Candidate:

  • Knowledge of government plans or Medicare and Medicaid populations.
  • Ability to complete assessment reviews, and/or care plan development.
  • Good oral and verbal communication skills.
  • Good organizational and self-motivational skills.
  • Knowledge of information and techniques in providing excellent patient care
  • Knowledge of administrative and office procedures and systems such as electronic transmission via facsimile and/or  internet
  • Good computer skills including the use of office procedures and terminology
  • Ability to maintain confidentiality
  • Ability to work at all health center sites
  • Understanding of the complexities of integrating services
  • Knowledge of data management through use of IT

 

Education:

  • Graduate of an accredited school of nursing required
  • Valid license as a Registered Nurse in the State of Missouri required
Myrtle Hilliard Davis Comprehensive Health Centers, Inc
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