QM Quality Improvement Coordinator

The Quality Improvement Coordinator is responsible for coordinating Quality Improvement activities surrounding UCLA Medical Group patients. The key responsibilities include identification of interactions with patients for completion of gaps in care/preventive health measures, non-clinical QI studies, health system navigation, patient advocacy and linkage to resources, and longitudinal care delivery. Quality Improvement Coordinators centrally support the outpatient clinics and work as an extension of the trusted clinician to manage projects for overall population health management. Work is assigned through reporting registries (ACO, EHR). Quality Improvement Coordinators report to the Manager of Quality Management and receive guidance from the Quality Improvement Nurse Specialists (RN and LVN). They must work collaboratively with the clinic physicians, office staff, and managers to promote patient care.

Key Responsibilities include:

• Ensuring care coordination during outreach to patients; review health record in its entirety to educate/coach patient on care plan, help patient complete and schedule any outstanding referrals, and connect patient to care team members
• Review of health maintenance and other databases to identify completion of gaps in care. Review any outstanding care plans and orders/referrals.
• Referral review (including home health, DME, specialty, testing)
• Schedule and coordinate follow-up appointments with specialists and primary care. Also, educate patients on alternate sites of care including Urgent Cares and same day appointment availability.
• Coordinate care plans with outside providers
• Send mailings/letters to patients to encourage follow-up and compliance with gaps in care
• Document telephone conversations, email exchanges, in-person conversations accurately, appropriately, and in a timely manner in the electronic health record
• Work with payor/plans to facilitate referrals and prior authorizations for urgent services
• Provide support to Care Team by identifying key patient issues and works with Manager of Quality Management, Clinical Advisors, Providers, and Practice Managers to develop action plans and implementing action plans
• Assist in development of forms/processes related to clinical activities that will help the care team maintain consistency in providing a high level and efficient level of clinical service for the identified patient
• Assist in development of educational materials for patients and staff -which may include development of materials, handouts, forms, etc
• Assist in conducting operational assessments including observational analysis, document review and data collection. Provide recommendations for change in operations as appropriate
• Additional duties included