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Pomona

    care manager and quality improvement coordinator - Phillips Ranch, CA , USA, United States - BLEHEALTH, LLC

    BLEHEALTH, LLC
    BLEHEALTH, LLC Phillips Ranch, CA , USA, United States

    1 week ago

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    Description
    BLEHEALTH, LLC -

    Essential Duties and Responsibilities: include but are not limited to the following functions.


    MUST HAVE EXPERIENCE WITH UDS AND HEDIS IF YOU DO NOT HAVE THE EXPERIENCE, PLEASE DO NOT APPLY.

    • Provide care management services

    • Engage members

    • Perform coordination of care, and transition of care.

    • Connect members with resources.

    • Create reports.

    • Improve and drive Quality Improvement across all areas.

    • Drive to clinic locations

    • Engage in process improvement and work with other departments as needed in order to ensure organization-wide improvement.

    • Develop policies, procedures, and protocols for the department using knowledge of Quality Improvement principles, practices, and procedures.

    • Work directly with the clinic staff in establishing, refining, and implementing developed policies, procedures, and protocols for use in the clinic.

    • Assist with the tracking of all UDS, HEDIS clinical indicators on a monthly basis and reporting these measures to the supervisor.

    • Assist with credentialing of Providers

    • Assist with audit

    • Educate and facilitates the use of the PDSA model.

    • Facilitate CAP as determined by QIC when metrics do not progress toward the target.

    • Monitor effectiveness of implementation.

    • Provide written and verbal reports of findings to QI Director.

    • Maintain written reports of findings and activities.

    • Attend training programs as assigned/approved by supervisor.

    • Attend both internal and external meetings.


    Qualifications:


    Education:

    • Bachelor's degree in health sciences, business, healthcare administration, health information management, engineering, or other relevant field.

    • Must know Excel, PowerPoint.

    • Must know how to create a PowerPoint presentation

    • Must know how to use Excel.

    • Minimum 1 year of work experience in healthcare.

    • Current CPR certification is required.




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