Clinical Quality Specialist

Hawaii Island Community Health Center
Job Title:
Clinical Quality Specialist
POSITION FUNCTION SUMMARY
Under the direction of the Clinical Quality Supervisor or Quality and Population Health Department Manager, the Clinical Quality Specialist is responsible for reviewing, tracking, and processing quality program related data.
Prepares and submits data as required by clinical operations, grants and programs, and federal and state reporting.
Collaborates with patients, providers, payors, and support staff to coordinate patient preventative care services and care gap closures.
ESSENTIAL DUTIES AND RESPONSIBILITIES
This position may have various work assignments within HICHC.
This description is intended to be generic in nature, and as such it does not detail all duties and responsibilities of the job assignment.
Various duties, responsibilities and accountabilities may be assigned to an incumbent in this position depending on clinic needs, and may include but not be limited to the following:

Collaborates with health insurance plans to promote quality patient care through quality programs such as P4P, ACO, HEDIS, CMS, etc.
Works to remedy care gaps and/or health reminders as defined by payor groups and quality programs.
Collects and delivers supplemental documentation as requested by health insurance plan programs.
Collaborates with the care team (patient, provider, payor, support staff, etc.) to conduct patient health maintenance.
Works with leadership team to develop workflows to close payor care gaps.
Coordinates appointment scheduling, protocol screenings, health education, and follow-up as appropriate.
Assists and participates in quality initiatives and efforts, including support of the Quality Improvement/Quality Assurance Plan, quality incentive programs, and quality campaigns
Promotes and supports the Patient Centered Medical Home (PCMH) primary care model.
Effectively uses, interprets, applies, and communicates data and information from multiple sources.
Assists in the identification, investigation, and resolution of data issues.
Carries out activities including data entry, collection, analysis, validation, and reporting.
Continuously monitors performance and quality plans to identify areas of improvement.
Reviews quality measures from various measure stewards (UDS, CQM, HEDIS, etc.) for opportunities of performance improvement.
Performs other duties as assigned.
POSITION SPECIFICATIONS Requirements of Position
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience

High School graduate or GED certificate required.
2 years of related experience in health care, OR any equivalent combination of experience, training and/or education approved by Human Resources.
Associate's Degree (two-year college or technical school) in related field is preferred.
Experience in a Federally Qualified Health Center is preferred.
Licenses and Certifications

Must maintain current BLS certificate.
Knowledge, Skills and Abilities

Proficient in use of the electronic health record (electronic medical record) to record and retrieve patient health information, obtain reports and evaluate documentation and associated charges.
Knowledge and understanding of data mining.
Ability to be flexible and work both independently and in a team environment.
Interpersonal relations and customer service skills; facilitating interdepartmental, inter-clinical operations.
Good organizational and self-management skills, including time management, document handling and management, etc.
Excellent computer skills, including word processing, spreadsheet and database applications.
Understand and proficiently use systems and programs to investigate and resolve data integrity issues, including running and analyzing reports.
Demonstrated skill and knowledge of computer systems including but not limited to word processing, spreadsheet, database, and electronic communication software applications.
Ability to pay attention to detail, maintain accurate records, and maintain confidentiality.
Language Skills

Ability to read and interpret documents such as government regulations and guidelines, patient records, operating and maintenance instructions, procedure manuals, etc.
Ability to write at an above average level of competence, including internal reports and memoranda.
Ability to communicate with diverse groups of people to include staff and providers and patients.
Ability to communicate effectively with patients and their families to make their visit a pleasant experience.
Sensitivity to the multicultural nature of the service area population and may be required to communicate in another language.

Personal Characteristics
Being a team player, self-starter working well with minimal supervision, high integrity, good personal habits, regular work attendance, courteous and friendly, able to work well with diverse groups of people, organization of multiple tasks and projects, and gain and maintain respect of other, both inside and outside HICHC and the communities it serves.