Clinical Quality Project Coordinator

The Clinical Quality Project Coordinator is responsible for coordinating medical record retrieval activities, including in-person retrievals at provider offices and healthcare facilities. Responsibilities include submitting and tracking record requests, monitoring and following up on outstanding requests, performing quality checks of received records for completeness and accuracy, and resolving or escalating retrieval barriers. The position maintains accurate documentation of retrieval activities and works with internal teams, provider and vendor contacts to ensure timely completion of medical record requests, supplemental data submissions and project goals.

This position has a hybrid work location: Remote, office-based, and in the field as needed. Office location is 100 Church Street, New York.

Duties & Responsibilities:

• Coordinates medical record retrieval activities from provider offices, hospitals, clinics, and other healthcare facilities, including in-person/on-site retrievals as required

• Submits, tracks, and monitors medical record requests through approved retrieval methods and maintain accurate documentation of request status and activity

• Conducts timely follow-up on outstanding requests and work with provider contacts to resolve barriers impacting record retrieval; escalate unresolved issues as appropriate

• Performs quality checks of received medical records to ensure documentation is complete, accurate, legible, and responsive to the request; proactively follow up on incomplete or missing records

• Utilizes internal systems, electronic medical records, provider portals, Microsoft Excel, and other approved tools to track, reconcile, and report retrieval activity

• Provides status updates on retrieval progress, outstanding requests, barriers, and completion rates to management and project stakeholders

• Maintains confidentiality and handle medical records and protected health information in accordance with Healthfirst policies and applicable privacy and security requirements

• Meets established productivity, quality, accuracy, and turnaround-time expectations
• Supports designated team supplemental data training and submission reconciliation activities for providers and vendors as required

• Participates in required meetings, training, and project activities. Performs additional duties as necessary and as directed

Minimum Qualifications:

• HS diploma or GED from an accredited institution
• Ability to travel around the NYC metro area (five boroughs) and Long Island as necessary

Preferred Qualifications:

• Associate’s degree or higher from an accredited institution
• Prior experience in Managed Care/Health Insurance, in a health-related field or environment
• Knowledge of HEDIS/QARR and/or Medicare Stars
• Strong working knowledge of Microsoft Office Suite and Outlook

Compliance & Regulatory Responsibilities: Noted above

License/Certification: N/A

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.

Know Your Rights

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $58,900 - $80,070

• All Other Locations (within approved locations): $51,000 - $74,880

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

About Us

Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. This value-based care model is the foundation of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you.

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