Quality Coordinator - TSS

Quality Coordinator

Guaynabo, PR

ABOUT US

At Triple S, we are committed to provide meaningful job experiences for Valuable People (Gente Valiosa). We encourage an environment of very high ethical standards, always excelling in service, collaboration among the company, agility to deliver timely, and embracing accountability for results.

When you join Triple S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.

Let's build healthier communities together, join now!

ABOUT THE ROLE

The Quality Program Coordinator contributes in planning, executing, and implementing activities which contribute in Complying with the Quality Management Program.

WHAT YOU'LL DO

• Supports the accomplishment of strategic plans which impact the Quality Program.

• Provides support to the Quality Analytics Manager in the management and implementation of the program activities.

• Provides leadership and offers possible courses of action for the implementation of the Quality Program related activities.

• Demonstrates problem solving, leadership, conflict management, and team building skills in order to ensure a productive work environment and achievement of goals.

• Analyzes and revises the Quality Management and Improvement Program (QMIP) in order to present the annual revisions to the Quality Management and Improvement Committee and Board of Directors.

• Is responsible of updating weekly and monthly reports of the Quality Program initiatives.

• Serves as a key contact with HEDIS Auditor and Audit staff.

• Coordinates annual HEDIS medical record collection and/or abstraction process with Quality Supervisor and Quality Analytics Manager.

• Coordinates HEDIS on-site audit in order to guarantee operational areas participation and compliance.

• Assists the Quality Analytics Manager in the development of training materials, templates, processes and procedures, presentations and reports related to the Quality Program.

• Collaborates with the team regarding work flow process improvement and document management.

• Coordinates meetings, trainings, and activities related to the Quality Management Program and all applicable regulations milestones and due dates.

• Accountable for implemented logs related to the Programs operation.

• Serves as a liaison between the internal office staff and external staff as well as physician's offices.

• Sends, monitors, receives, analyses and revise ROADMAP Sections completed by all operational areas and vendors.

• Telephonically complete and document 10 (ten) PCP Satisfaction Surveys per External Quality Review

• Analyst per month and document findings.

• Facilitates all quality initiatives through the identification of information needed and report requests to Data Analyst, DAU and other operational areas, when applicable.

• Other tasks as assigned by the Management and which are essential to the position. vendor oversight initiatives and actively participates in weekly calls and face to face meetings.

WHAT YOU'LL BRING

Bachelor's Degree (BD) in Business Administration, Arts, Science, Criminal Justice or related area with 1 to 3 years of related experience and/or training preferable in the Health Insurance Industry. Or Associates Degree (60-64) college credits in Business Administration, Arts, Science, Criminal Justice or related area

with 3 to 5 years of related experience and/or training preferable in the Health Insurance Industry. Or at least 5 years of this experience in lieu of.

CLOSING DATE:

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, gender, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.

Equality Employment Opportunity/Affirmative Action for Minorities/Females/People with Disabilities/Veterans". Employer with E-Verify to verify the eligibility of employment of all the new employees.

We encourage Females, Veterans and Disabled to Apply