Summary:

The Sr. Coordinator, Clinical Operations Quality, reporting to the Senior Manager, Accreditation and Regulation, will assist in coordinating and implementing the quality management and quality improvement programs for organization, data collection and analysis of complaints, grievances, variances, incidents, and patient surveys. This individual will be responsible for creating and analyzing reports for quality leadership team and regulatory specialists.

Essential Duties and Responsibilities:

• Assists quality management team and regulatory specialists to plan, design, implement, and maintain a comprehensive clinical practice continuous quality improvement program including audit and risk management
• Identify and monitor organization efforts to ensure compliance with internal and external regulatory requirements
• Coordinates the gathering of data and preparation of reports to meet the requirements of NCQA and other regulatory/accrediting agencies, including health plans, provider, patient satisfaction, universes, complaints and grievances
• Assist with evaluating variance and other data to identify quality improvement opportunities and risk management issues
• Meet with internal and external stakeholders to identify and problem solve quality improvement issues
• Develop, maintain, and manage detailed project plans, task due date(s), and major milestone timelines for assigned projects.
• Coordinate with stakeholders to keep projects aligned and on track for timely completion.
• Ensure on-time completion of deliverables in conjunction with quality managers, directors and teams.
• Facilitate and coordinate meetings as needed, documenting summaries and communicating next steps to appropriate stakeholders.
• Ensure (in collaboration with quality managers, directors and teams) that deliverables meet company policies and procedures, NCQA, MOC, CMS, and SLA requirements per our contracts and accreditations.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Required Education and Experience:

• Bachelor's degree, Nursing degree, or other comparable healthcare experience
• One (1) year experience supporting organizational quality activities including but not limited to CQI principles, audits, complaints and grievances, patient satisfaction reports

Knowledge, Skills, and Abilities:

• Knowledge of CQI principles, practices, methods, and tools
• Ability to analyze QI data and identify trends and corrective actions
• Skill in conducting QI checks of medical records and other clinical documentation and performing patient satisfaction surveys
• Extensive knowledge and proficiency with all Microsoft tools including PowerPoint, Excel, Outlook, etc.
• Ability to manage multiple, competing priorities with minimal oversight and quick deadlines.
• Ability to be both a strategic and tactical change agent in the healthcare space
• Strategic solution-seeker who sees opportunities when others see barriers
• Strong interpersonal skills and ability to communicate effectively
• Ability to handle ambiguity, including applying critical thinking and the desire to work in a fast-paced start-up environment.
• Acute attention to detail.
• Excellent written, verbal and organizational skills.
• Ability to build and maintain collaborative relationships with key members of other departments within the organization.

Physical Requirements

• This job operates in a professional setting. While performing the duties of this job, the employee is regularly required to sit or stand for extended periods of time. Normal manual dexterity is required.
• Normal speaking and hearing abilities to interact with others in an office environment, over telephone or other video conferencing platform.
• The employee is occasionally required to stand; walk; and reach with hands and arms and continuously repeat the same hand, arm finger motion many times as in typing.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company. All requests for proof of vaccination or for exemptions from the vaccination requirement will be subject to any limitations stipulated by current state and/or federal laws.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated