Performance Improvement Coordinator
Our Mission: Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.
Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.
Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!
Position Purpose: The Performance Improvement Coordinator works in collaboration with physician practices to execute on opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance.
- Works in collaboration with physician practices to target opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance
- Maintains collaborative team relationships with peers, colleagues, and physician practices in order to effectively and efficiently achieve goals and foster a positive work environment
- Supports process improvement to enhance physician and staff workflow and drive performance improvement
- Supports medical record data review/collection as it relates to performance improvement goals for risk adjustment and quality management purposes, including contractual obligations
- Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment and Quality performance measures, like HEDIS
- Interacts with providers regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
- Coordinates and communicates with local Health Plan management to track and share data with practices on performance against goals, escalating issues at the practice level in a timely manner
- Works collaboratively with assigned practices staff, including Performance/Quality staff and Office Managers to coordinate improvement efforts
- Implements performance improvement plans at the practice level and support monitoring and evaluation of performance by following policies and procedures for tracker data entry and maintenance
- Produces and maintains record by keeping documentation updated real-time and reporting progress on a weekly basis
- Provides dashboard reports to providers and practices with recommendations on improvement, establishing and implementing accountability for performance improvement
- Educates providers and leadership on clinical indicators to capture the severity of illness of the patient
- Assists in preparation of training materials (Provider and Practice-facing)
- Provides leadership and staff with training, on-site collaboration and on-going performance reporting
- Valid Arizona Driver’s License
Education / Experience / Other Requirements
Education: Medical Assistant or LPN license preferred, or equivalent clinical experience
- Knowledge of quality metrics and risk adjustment preferred
Skills & Abilities:
- Ability to demonstrate excellence and set high standards of performance for self and all coworkers, including delivering high-quality work and results
- Ability to project manage, organize, and effectively plan to support working on multiple and competing priorities, including paying appropriate attention to details
- Ability to work independently and manage time well
- Ability to organize and prepare training materials, conduct in-person and computer-based training
- Ability to maintain stable performance and poise under pressure and demonstrate a strong sense of diplomacy and professionalism
- Ability to demonstrate effective verbal communication one to one, in small groups and in public-speaking (training) contexts, including the ability to articulate areas of areas of opportunity to providers and practices as well as health plan leadership
- Ability to demonstrate effective written communications by writing clear, precise, well-organized emails and other written correspondence
- Ability to use technology effectively and proficiently including basic Microsoft Office product
- Required to attend meetings as necessary; some will offer virtual attendance while some will require in-person attendance at the local Health Plan office