Clinical Quality Coordinator-Transitions of Care

Job Summary

We are seeking a compassionate and organized Transition of Care Clinical Support team member to support patients as they move from hospital to home. In this role, you will conduct post-discharge phone interviews to assess patient needs, identify potential barriers to recovery, and help schedule timely follow-up appointments to reduce hospital readmissions. Ideal candidates are patient-focused, detail-oriented, and comfortable with phone-based patient interactions in a fast-paced healthcare environment. Must have a clinical background, RN, LPN, CMA etc. 

Essential Functions

• Implements and monitors quality improvement initiatives to ensure adherence to best practices, policies, and regulatory requirements.
• Supports teams as a subject matter expert on quality-related workflows, ensuring staff adherence to established procedures.
• Coordinates and tracks patient outreach efforts to close gaps in care, ensuring timely follow-up on quality attribution reports.
• Optimizes provider schedules by ensuring appointments address preventive care and chronic disease management gaps.
• Monitors and analyzes key performance indicators (KPIs) related to quality measures, providing feedback and accountability to stakeholders.
• Conducts regular rounding with providers and staff to reinforce best practices and identify workflow improvement opportunities.
• Assists in medical record audits, ensuring compliance with payer requirements and timely submission of quality-related documentation.
• Facilitates training sessions and provides ongoing support to enhance staff competency in quality care initiatives.
• Collaborates with data analytics and population health teams to ensure accurate reporting and performance tracking.
• Maintains compliance with all payer-specific quality programs, ensuring proper documentation and adherence to incentive program requirements.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Associate Degree in Healthcare Administration, Nursing, Public Health, or a related field required
• Bachelor's Degree in Nursing or a related field preferred
• 2-4 years of experience in quality improvement, population health, or clinical operations within a healthcare setting required
• Experience in working with payer quality programs and regulatory reporting preferred

Knowledge, Skills and Abilities

• Strong knowledge of quality improvement methodologies and healthcare regulatory requirements.
• Proficiency in electronic medical records (EMR) systems and quality reporting tools.
• Excellent communication and interpersonal skills to collaborate effectively with providers, staff, and leadership.
• Ability to analyze data, identify trends, and develop action plans for performance improvement.
• Strong organizational skills and attention to detail to ensure compliance with quality initiatives.
• Ability to adapt to evolving healthcare regulations and payer requirements.
• Strong problem-solving skills and the ability to drive accountability in a healthcare setting.

Licenses and Certifications

• Certified Medical Assistant (CMA)-AAMA preferred or
• LPN - Licensed Practical Nurse - State Licensure preferred or
• RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred
• CPHQ - Certified Professional in Healthcare Quality preferred