Provider Quality Coordinator II (Temporary with Benefits)

Job Category:  Administrative, HR, Business Professionals
Department:  Quality Improvement
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  5154

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Provider Quality Coordinator II will provide administrative and technical support to Potential Quality of Care Issue (PQI) reviewers by calling doctors' offices to have copies of medical records faxed or mailed; conduct phone and fax follow-up, to troubleshoot, investigate, and follow up on retrieval of missing medical record information. Clerical functions include downloading, scanning records for storage and retrieval, creating file folders for records, and retrieving records. Other responsibilities include reaching out to internal and external customers for deliverables related to PQI projects and initiatives, provide data entry and database maintenance support, providing project support to PQI nurse reviewers/specialists, provider quality/QI managers and directors on key project activities, and coordinating efforts across departments.  

Duties

Project Coordination: Follow up with internal and external customers to obtain information related to PQI projects and initiatives; call doctor's offices to have copies of medical records faxed, or mailed, downloading records from electronic database or e-fax system. (30%)

 

Data Entry: Maintain up-to-date databases and tracking logs; assist with data collection to support PQI projects and initiatives. (30%)

 

Scheduling: Schedule meetings with internal and external stakeholder to help move forward PQI projects and initiatives.  (25%)

 

Activity monitoring and tracking: Maintain an accurate and up-to-date log of completed activities; maintain database of deliverables for PQI projects and initiatives; appropriately raise issues to initiatives staff to ensure timely receipt of deliverables. (5%)

 

Perform other duties as assigned. (10%)

Education Required
High School Diploma/or High School Equivalency Certificate
Education Preferred
Associate's Degree
Experience

Required:
Minimum 0-1 years of experience performing administrative tasks in an office setting with 1 year experience in electronic data entry. 

 

Preferred:  
At least 0-1 years experience in a managed care setting.  

Skills

Preferred:
Must be familiar with medical office processes and medical terminology.

 

Computer literate with Microsoft Office (Word, Excel, & Outlook email).

 

Excellent telephone skills.

Persuasion Skills: QI Coordinator will be required to persuade L.A. Care departments and network physicians/PPG's to supply needed information, data, and reports.

 

Preferred: 
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.

Licenses/Certifications Required
Licenses/Certifications Preferred
Medical Terminology Certificate
Medical Coding Certification
Required Training
Additional Information

 

L.A. Care offers a wide range of benefits including

  • Medical, Dental and Vision
  • Wellness Program
  • Paid Sick Leave


Nearest Major Market: Los Angeles

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