Call Center Customer Service Representative

Job Title: Quality Coordinator

Location: San Ysidro, CA 92173 (onsite with the possibility of hybrid after training)

Schedule: Monday to Friday 8am - 5 pm

Duration: 20 Weeks

Pay: $24 - $26 per hour

Position Summary:

The Call Center Representative Quality Coordinator will place a high volume of outbound calls to assist in all activities related to the organization’s quality management program. This includes assisting with organizational adherence to federal, state, and other regulatory requirements; monitoring and maintaining compliance with NCQA PCMH recognition standards; TJC ambulatory accreditations standards; and facilitating a state of continuous clinic audit readiness.

Responsibilities:

• Place a high volume of outbound calls on the phone to do outreach.
• Handling excel spreadsheets.
• Scheduling appointments.
• Track and support as directed by the Quality Manager continuous audit readiness activities.
• Support care team training activities to improve clinical quality performance and adherence to regulatory health plan and other program participation requirements.
• Coordinate peer review activities by maintaining an annual calendar, preparing records for review, and collecting data for review.
• Provider administrative support for quality improvement studies addressing areas of opportunities. Maintain and update departmental project work plans as needed.
• Participate in departmental PCMH and CQI meeting for alignment and tracking of active projects.
• Facilitate project milestones by coordinating follow-up activities internally and cross departmentally.
• Provides support in capturing and updating policies, procedures, practice guidelines, and clinic protocols that impact clinical quality.
• Keep abreast of PCMH and TJC program requirements and updates.
• Assist in gathering data for quality related reports for regulatory submission and as requested by the board, Executive, and Department leadership.
• Adheres to the company and department’s attendance and punctuality policies and practices.
• Perform other duties as assigned.
• Enhance professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
• Attend meetings as required and participate in committees as directed.

Qualifications:

• Education Required (Minimum level of education):
• High School Diploma

Training/Certification:

Valid California driver’s license with appropriate insurance.

Experience Required (Minimum level of experience):

• Call Center experience in a health related setting is a plus.
• Two years’ experience in healthcare or a closely related field; familiarity with the PCMH model of care, the continuum of care, transitions of care, and quality improvement processes.
• Must have EPIC experience
• Must be Bilingual (English/Spanish)
• Health related call center experience is a plus
• Must have minimum 2 years’ experience
• Track key performance indicators related to regulatory clinic compliance audits, surveys, and studies by health plans, federal, and state agencies.
• Experience in chart review and medical record documentation.
• Excellent oral and written communication skills required.
• Proficient in Microsoft Excel, Power Point and Word and attention to detail.
• Working Conditions and Physical Requirements: Prolonged periods of sitting and standing, driving within the country to travel between clinic locations and to occasional community partner meetings.
• May be required to work evenings and/or weekends.