QI Coordinator

Caresource Indianapolis , IN 46218

Posted 2 months ago

Role and Responsibility:

  • Provides general administrative support and duties to the Enterprise Quality Improvement (QI) team

  • Responsible for interacting with the QI team to develop and implement QI projects, activities and studies (PIPs, QIPs, EDV, etc.)

  • Coordinate and facilitate QI Department team meetings by scheduling, preparing agendas, taking minutes and coordinating all follow up for next meeting

  • Assist in the preparations of QI presentations, coordinate the documentation and collaborate schedules of external and internal QI activities and projects

  • Develop detailed reports of data for analysis of readmissions, complications, sentinel events, grievances and potential quality of care issues for QI department

  • Research Internet, OnBase, Sharepoint, Streamline and other systems to support QI projects and activities

  • Retrieve all Clinical Grievances (all products) and Potential Quality of Care, Sentinel events, etc. routed to Enterprise QI and disperse daily to the appropriate QI reviewer

  • Maintain all QI projects, activities, etc. in a secure manner

  • Request medical records, information, etc. from providers/facilities to assist in QI investigations

  • Assist in Quality Enterprise Committee and Market Quality Improvement Committees preparation of reports, documents, etc.

  • Coordinate dental and vision clinical grievances and assist in process improvement activities related to streamlining these issues

  • Develop policy and procedures, Quick tools, SOPs for the QI Department

  • Track and trend potential member risks, sentinel events, and other issues in regards to specific providers, facilities, etc.

  • Meeting agendas, minutes, document preparation, as needed

  • Support the QI Department in filing, printing, copying, scanning or applicable information

  • Demonstrates aptitude for project management by collaborating with internal/external teams

  • Respond to, forward and return calls from providers, facilities and/or other CareSource staff

  • Examine and identify ways to improve existing processes/workflows.

  • Under the direction of the Enterprise QI Manager and Enterprise QI Director is responsible for the coordination of QI activities, reports, studies, etc.

  • Perform any other job-related instructions, as assigned

Requirements

Education / Experience:

  • High School diploma or equivalent is required

  • Experience in Managed Care preferred

Required Competencies / Knowledge /

Skills:
  • Intermediate skill in Microsoft Excel, Access and Word.

  • Intermediate skill level with SharePoint

  • Strong written and verbal communication skills

  • Ability to work independently and within a team environment

  • Familiarity of the healthcare field and managed care

  • Effective listening and critical thinking skills

  • Strong interpersonal skills

  • Effective problem solving skills with attention to detail

  • Ability to develop, prioritize and accomplish goals

  • Technical writing skills

  • Ability to coordinate complex projects

  • Filing and organizational skills

  • Ability to work with a variety of disciplines and levels of staff across departments

  • Perform other job related instructions as requested when applicable

Licensure / Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit/stand for long periods of time.

  • Ability to lift heavy objects weighing up to fifty pounds

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QI Coordinator

Caresource