Quality Operations Coordinator

🔥 13 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $26 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

🚫👨‍🎓 No degree required

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WelbeHealth

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $30M Series C on 2020-02

Healthcare • Healthcare Insurance

WelbeHealth is a healthcare organization that provides comprehensive medical care and personalized support to help seniors age well at home and in their communities. They offer a Program of All-Inclusive Care for the Elderly (PACE) which includes services such as medical care and coordination, dental, vision and hearing services, in-home care, prescription deliveries, transportation, physical therapy, meals, social activities, and more, often at no cost to eligible seniors. WelbeHealth's dedicated team prioritizes the needs of seniors by offering a coordinated approach to healthcare, ensuring access to highly skilled professionals across various areas of healthcare, and emphasizing patient-centered care. Their goal is to improve the quality of life for seniors by enabling them to live independently with robust support from a multidisciplinary team.

📋 Description

• Deliver support and service to PACE market operations through record review • Collect data and audit participant electronic health records using quality-improvement tools • Complete reporting and confirm all regulatory-required elements • Identify documentation gaps, trends, deficiencies, and root causes • Collaborate with clinical and operational teams on process improvement and regulatory readiness • Identify potential deficiencies and facilitate and monitor corrections to ensure EHR data integrity • Monitor participant medical records for complete and timely documentation • Report policy and procedure violations to the Quality Operations Supervisor • Participate in team documentation, process improvements, and QO team initiatives • Conduct medical records audits for timely and accurate required documentation • Prepare documents and universe lists for audit desk-review submissions • Assist with EMR navigation and impact analysis • Review and reconcile assigned regulatory logs • Complete required tasks, investigations, and notifications accurately and timely

🎯 Requirements

• Associate’s degree preferred; may substitute three years’ experience in lieu of education • Minimum two (2) years’ work experience in a healthcare setting or related areas • Familiarity with healthcare quality standards, auditing, regulatory requirements, documentation, and maintaining operational controls in a regulated environment • Experience working with grievances, complaints, appeals, or member/provider issues within a healthcare, health plan, managed care, PACE, or other regulated healthcare environment is highly desired • Bilingual is a plus • Ability to multi-task in a challenging environment • Excellent communication, listening, and organization skills • Extensive MS Office suite experience; intermediate to advanced proficiency desired • Proof of vaccination or a vaccine declination form required prior to employment

🏖️ Benefits

• Medical insurance coverage (Medical, Dental, Vision) • 17 days of personal time off (PTO) • 12 holidays observed annually • 6 sick days • 401K savings + match • Comprehensive compensation package including base pay and bonus • Additional benefits • COVID-19 vaccination policy and infection control/PPE standards