Overview
Quality Assurance Lead, Care Team & Operations – (Hybrid) Jobs in Coral Springs, FL at Cruise Planners
Lakeside Pediatrics, a leading provider of children’s healthcare services in Lakeland, Florida and the surrounding communities, is looking for a Quality Assurance Coordinator & Credentialing Assistant (QACA). This position maintains facility and provider credentialing, the Patient Centered Medical Home recognition, tracks HEDIS scores, assists the Quality Assurance Coordinator in creating, maintaining and generating reports, data analysis and presentation materials; works within and assists in coordinating team-based care seeking the common purpose of efficient, cost effective, quality healthcare; assists in proactively implementing new ideas and solutions to organizational challenges in meeting quality and efficiency standards.
The qualified candidate will meet and work with the Quality Assurance Coordinator to understand the data being reported both through internal reports and externally from health plans, regulatory agencies and other quality assurance organizations; meets and coordinates with health insurance payer quality assurance representatives on a regular basis to review and understand reports directly related to the national scoring standards and the practices’ performance within those standards; coordinates with other department managers, providers and front-line staff to complete care gap reports and required patient follow up.
The candidate must have the ability to understand and demonstrate knowledge of NCQA Patient Centered Medical Home standards, Value based care concepts, HEDIS scoring and management, quality management programs in the medical industry, quality concepts and the ability to assist in the creation of performance improvement programs, risk management practices, regulatory surveys/reviews.
The qualified candidate is a professional administrative specialist who maintains the credentialing of the medical provider staff with governmental agencies, healthcare and insurance companies, facilities and professional organizations including licensing and registration of the company’s two facilities. The credentialing specialist performs clerical, data entry, secretarial and delegated administrative job duties and acts as a liaison between the Medical Staff and Administration.
The qualified candidate will perform, complete and prove competency in the following:
Proficient working knowledge of personal computer and software applications used in job functions including but not limited to word processing, graphics, databases, spreadsheets, reporting through both application based and web-based products.
Ability to learn and manage accreditation requirements, processes, gather and analyze data and trends.
Exceptional organizational skills and demonstrated project management skills.
Exemplary customer service, communication and interpersonal skills are imperative.
Ability to work independently on assigned duties and projects.
Creates and maintains physical and electronic files.
Attendance at both onsite and offsite educational opportunities.
Maintains strict confidentiality and complies with HIPAA Privacy standards as they relate to the healthcare clinic and Protected Health Information (PHI).
Education / Work history required – minimum of 2-year degree in healthcare related studies plus 2 years of clinical healthcare experience, or 4 years of hands-on experience in healthcare including at least 2 years of participation with proven working knowledge of healthcare quality programs and quality program statistics. Pay will be commensurate with education and experience. EEOE & DFWP
Job Type: Full-time
Pay: $22.00 – $26.00 per hour
Expected hours: 40 per week
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
Schedule:
8 hour shift
Monday to Friday
Education:
Associate (Required)
Ability to Relocate:
Lakeland, FL 33813: Relocate before starting work (Required)
Work Location: In person
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Title: Quality Assurance Lead, Care Team & Operations – (Hybrid)
Company: Cruise Planners
Location: Coral Springs, FL
