Clinical Quality Project Coordinator

General Information

Req ID: R022645 State: New York Work Type: Hybrid

Description and Requirements

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