Overview
Quality Care Coordinator/Bilingual/Vietnamese Jobs in Orange – California – USA at Eastridge
Position: Quality Care Coordinator (Bilingual/Vietnamese)
Job Description
Job Description
Eastridge Workforce Solutions is hiring an experienceQuality Care Coordinatorwho is bilingual in Vietnamese and English, for one of the areas largest healthcare providers. In this role, theQuality Care Coordinator(QCC) assists the providers andleadershipteam in accomplishing the highest percentage of member compliance for the annual goals of HEDIS, IHA, and STAR measures, as well as AnnualWellnessVisits.
Additionally, the QCC will enter data from medical record reviews, document conversations held with members or healthcare providers, and review data on reports.
Through a combination of mailing patient due letters oreducationflyers, calling the patient and/or healthcare provider, creating referrals, and conducting warm-handoffs; the QCC is the professional representative of striving forpatient satisfaction. Qualified candidates are encouraged toapply todayfor immediate consideration.
RESPONSIBILITIES
Manage assigned member outreach (appointment calls, quality measures due, annualwellnessvisits, follow-up calls, etc.) by closing gaps in care and increase HEDIS/IHA/STAR/P4P scores.
Receive inbound calls from members and assist with tracking data, etc.
Document details the healthcare provider conducts in quality platforms (Cozeva, etc)communicationmodule foraccurate tracking.
Provide generaleducationto encourage the staff and providers to complete the required, “due” quality measures.
Input alerts in EMR to notify providers/staff of current outstanding items due for completion.
Develop and maintain the P4P and HEDIS training manual and documentation in accordance with department standards and industry best practices
Assist the Manager in the coordination and preparation of the HEDIS medical record review, which includes outgoing review of records submitted by providers and the annual HEDIS medical record review.
Provide the providers, staff, and members with the nearest contracted Lab location to have lab services rendered.
Assist as needed in support of accreditation activities such as NCQA reviews, CAHPS, and state audits.
Ability to create CMS
1500 forms from the provider code data
Ability to discuss with providers the strengths and weaknesses while coding
Request medical records from healthcare providers to verify services were rendered, per member’s verbal reporting.
Follow all departmental Policies and Procedures for audit compliance.
Assists outside departments with facilitating PCP transfers, answering questions, and conducting follow-up calls; as needed.
Populate the database with new member demographic information.
Helps with special projects, as needed.
QUALIFICATIONS
High School Diploma or GeneralEducationDevelopment (GED) required.
3 years of IPA/HMO experience and one plus (1+) year/s in P4P/HCC/CMS Star Programs experience.
Ability to project excellent customer service, negotiation, andconflict resolutionskills via telephone while maintaining a professional demeanor.
Bilingual in Vietnamese and English is required.
Benefits:
Use this link bit.ly/2023-Benefits to learn more about benefits available to Eastridge’s temporary employees.
From time to time Eastridge’s clients may offer additional benefits to Eastridge employees while on assignment.
Information about those benefits will be communicated when applicable.
Eastridge Workforce Solutions is an equal opportunity employer and all qualifi…
Title: Quality Care Coordinator/Bilingual/Vietnamese
Company: Eastridge
Location: Orange – California – USA
Category: Healthcare, Administrative/Clerical
