You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a Clinical Quality Manager to oversee and implement high-quality health services. The primary responsibility includes managing patient interactions, including prescription requests, lab results, and patient education. The role also involves outbound communication with patients and collaborating with healthcare providers, ensuring adherence to established protocols.
Key Responsibilities
- Strictly adhere to department metrics and protocols for handling prescriptions, lab results, medical inquiries, and more.
- Primarily manage outbound calls and assist with inbound call queues, strictly adhering to protocols.
- Conduct patient assessments, specifically Care for Older Adults Function Assessments.
- Educate patients on health conditions, routine screenings, and assist with appointment scheduling.
- Communicate with providers to obtain needed evidence of completed lab work and screenings.
- Assist patients in finding and connecting to community resources for non-medical needs.
- Document all calls and actions taken within core systems.
Qualifications
- Active, unrestricted Registered Nurse eNLC Compact licensure in state of residency
- Extensive knowledge of Medicare HEDIS/Stars measures
- Experience managing complex and concurrent projects
- Proficient in Microsoft Office applications with intermediate or better Excel skills
Experience
- 1 or more years of experience in HEDIS/Star programs, preferably in a clinical quality consultant role
- 2 or more years of Call Center or Telephonic Outreach experience
- 2 or more years of experience with data analysis and/or quality chart reviews
Skills
- Technical skills: Microsoft Office proficiency, including databases and Excel
- Soft skills: Communication, collaboration, and patient interaction
Additional Requirements
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
