Quality Improvement Coordinator II
About this role
Quality Improvement Coordinator II
Position Purpose: Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communicate with agencies and providers. Perform quality on site reviews of delegated entities, physician office/clinics, resolve quality issues, generate written summary of findings and follow up as directed by the Medical Director and/or Credentialing and Quality Improvement Committee (QIC). Document, investigate and resolve formal and informal complaints, risk management and sentinel events related to quality of care issues. Audit medical records, review administrative claims and analyze data and interventions for quality improvement studies and activities.
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