Job Description
Job Description
Thank you for expressing your interest in pursuing a career with Valley Medical Group. We are a provider-owned, multi-specialty group. We proudly serve a diverse community of over 55,000 patients at four locations throughout the Pioneer Valley.
Valley Medical Group is looking for a Quality Specialist to join our Family Practice team and work in our Greenfield Health Center. If you are looking for a dynamic environment, this is your opportunity!
NO NIGHTS! NO HOLIDAYS!
Position: Quality Specialist
Salary Range:
LPN $27.37 to $38.97 Hourly
MA: $20.56 to $29.28 Hourly
Location: Greenfield, MA
Hours: 40 hours, Monday-Friday generally between 7:30am and 4:00pm. Hours may vary depending on department needs. Exact schedule to be discussed at time of interview.
As a Quality Specialist, you will be assigned projects and roles that contribute to the quality program, provide chart review for regulatory and quality of care audits, provide review and data entry into EMR for the accurate documentation of quality measures and preventative services, review and maintain filing and follow up for patient experience, complaint and incident reporting program, including written correspondence with patients. The Quality Specialist will be either an LPN or Medical Assistant with knowledge of chronic diseases, medications, disease management guidelines, medical terminology, ICD-10 coding, and knowledge of Hierarchal Condition Categories. The Quality Specialist will use critical thinking, follow accepted process and procedures and collaborate with other departments and key personnel including Quality Physician, Quality Director, Health Information Coordinator, case management staff and clinical supervisors. This position is also involved in our Transitions of Care program, which outreaches to patients after they are discharged from an inpatient or skilled rehab/nursing facility stay.
A role model for Valley Medical Group core values of caring, respect, integrity and team work. Commitment to patient first focus and a passion for the delivery of high-quality care.
Job Responsibilities:
- Review/abstract information from transferred medical records to update EMR quality measures and preventative services for new patient charts
- Coordinate transition of care follow up phone calls with case management programs. Perform follow up phone calls, TCMS documentation for all appropriate patients not managed by risk contract case management staff. Update medication lists and problem lists as appropriate, schedule TCMS or Hospital/ER/SNF follow up appointments with PCP.
- Liaison with health plan quality and HCC programs, updating HCC and preventative services in the health plan software platform to meet metrics for performance.
- Review and file Incident and complaint forms. Follow up with appropriate managers and supervisors for outstanding or incomplete forms, send out correspondence letters to patients
- Review and manage patient experience data, initiate the patient complaint and incident review process for any comments provided less than 70% willingness to recommend, or comments that constitute a patient complaint regarding customer service or care.
- Perform chart audit and data abstraction as needed for health plan risk contracts
- Collaborate with other departments and key personnel including the Quality Physician, Quality Director, Health Information Coordinator, case management staff and clinical supervisors.
- Other Duties as assigned: Quality Specialist performs special projects as needed that include research and review of EMR data.
Required Qualifications:
- Current Massachusetts LPN License or Medical Assistant experience
- Graduate of an accredited school of nursing (if LPN)
- Knowledge of chronic diseases, medications, disease management guidelines, medical terminology
- Minimum of 2 years outpatient medical experience
- Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly with excellent accuracy and attention to detail
- Experience with using electronic medical records
If you do not meet all of the preferred qualifications, we strongly encourage you to apply and/ or inquire. We often have multiple open positions and could consider you for another opportunity with our organization.
Valley Medical Group offers:
- Medical, Dental & Vision Plans
- 401(k) Plan with Company Match
- Health Savings Account & Flexible Spending Account
- Generous Paid Time Off
- 7 Paid Holidays
- Company-Paid Long-Term Disability Insurance
- Company-Paid Life Insurance
- Voluntary Life, Accident and Critical Illness Insurance Options
- Company Wellness Program
- Employee Assistance Program
- Free On-Site Parking
We Value Employee Engagement and Inclusive Practices
Valley Medical Group (VMG) seeks to recruit, develop, and retain the most qualified workforce from a diverse candidate pool. We strive for every VMG staff person and provider to feel valued and be treated fairly, respectfully, and with dignity. We expect our employees to conduct themselves in a professional manner that promotes equal opportunity and prohibits unlawful discriminatory practices, including bias and harassment.
Fostering inclusion and belonging among our employees is critical to our success in providing high-quality patient care rooted in evidence-based practices and health equity. We have several initiatives that prioritize the employee experience, from an annual assessment of employee engagement to staff recognition events, various feedback mechanisms, and committees that promote an inclusive workplace.