Quality Improvement Coordinator II
Core
Conduct on-site reviews of delegated entities (physician offices/clinics) for compliance with quality, service performance, and utilization standards; audit medical records; and resolve quality issues.
Role type
Quality Improvement Coordinator
Builds
Quality improvement studies, corrective action plans, and utilization/quality reports for healthcare providers.
Domain
Healthcare / Quality Assurance
Required skills
Medical record auditing, data analysis, complaint investigation, contract enforcement, meeting facilitation, corrective action planning, policy development, best practice identification, program enhancement research.
Preferred skills
Nursing background, clinical quality experience, healthcare credentialing knowledge.
Technologies
None explicitly stated
Responsibilities
Perform on-site quality reviews of delegated entities, audit medical records, document and resolve complaints and sentinel events, schedule and chair meetings with providers, compile utilization and quality reports, develop Corrective Action Plans, recommend policy enhancements, coordinate QIC activities, oversee data submission enforcement.
Seniority
Mid-level, hands-on IC