CARE MANAGER AND QUALITY IMPROVEMENT COORDINATOR - BLEHEALTH, LLC

Essential Duties and Responsibilities: include but are not limited to the following functions.

MUST HAVE EXPERIENCE WITH UDS AND HEDIS! IF YOU DO NOT HAVE THE EXPERIENCE, PLEASE DO NOT APPLY. 

• Provide care management services
• Engage members
• Perform coordination of care, and transition of care.
• Connect members with resources.
• Create reports.

• Improve and drive Quality Improvement across all areas.

• Drive to clinic locations

• Engage in process improvement and work with other departments as needed in order to ensure organization-wide improvement.

• Develop policies, procedures, and protocols for the department using knowledge of Quality Improvement principles, practices, and procedures.

• Work directly with the clinic staff in establishing, refining, and implementing developed policies, procedures, and protocols for use in the clinic.

• Assist with the tracking of all UDS, HEDIS clinical indicators on a monthly basis and reporting these measures to the supervisor.

• Assist with credentialing of Providers
• Assist with audit

• Educate and facilitates the use of the PDSA model.

• Facilitate CAP as determined by QIC when metrics do not progress toward the target.

• Monitor effectiveness of implementation.

• Provide written and verbal reports of findings to QI Director.

• Maintain written reports of findings and activities.

• Attend training programs as assigned/approved by supervisor.

• Attend both internal and external meetings.

Qualifications:

Education:

• Bachelor’s degree in health sciences, business, healthcare administration, health information management, engineering, or other relevant field.

• Must know Excel, PowerPoint.
• Must know how to create a PowerPoint presentation
• Must know how to use Excel. 

• Minimum 1 year of work experience in healthcare. 

• Current CPR certification is required.