Quality Improvement Specialist-Associate (UTHP ADM Quality)

Job Summary:

Under direct supervision, responsible for performing a variety of clinical support functions for the outpatient setting including patient outreach, care gap analyses, and patient follow up to support the value-based care model.

Job Duties:

1.     Performs patient chart reviews to identify opportunities in patient care to satisfy HEDIS measure gaps.

2.     Maintains systems for storing and tracking HEDIS medical record documentation

3.     Documents in the Electronic Medical Record

4.     Outreaches and requests charts and medical records from other facilities to close gaps in pre and post care for value-based patients with quality needs

5.     Scans or uploads medical records into payor databases

6.     Performs patient outreach to schedule Annual Wellness Visits and Follow up appointments to fill gaps in care

7.     Performs pre-visit evaluations that identify gaps in care for the clinical team and post-visit evaluations that identify gaps in care after the visit

8.     Identifies, tracks, and follows up on gaps in care that cannot be or were not closed in the clinic

9.     Performs medication adherence reviews to identify and mitigate barriers to patients not taking their medication

10.  Coordinates and assists in processing hierarchical condition category attestation forms from payors

11.  Performs all other duties as assigned

Education:

High school diploma or GED equivalent is required.

Experience:

No experience required. Quality Improvement Specialist or Medical Assistant experience preferred.

Additional Licenses and Certifications:

None.

Additional Information