*** SALARY RANGE: $43280.26 to $62351.25 ***
Company Description
Patient Care Coordination is a Service Coordination Entity based in Philadelphia, PA, providing services in 67 counties in Pennsylvania. As a contracted partner with various healthcare organizations, PCC focuses on connecting participants to community services to maintain their health, safety, and independence. PCC's services include Community HealthChoices, Nursing Home Transition, and support for OBRA Waiver and Act 150 participants.
Role Description
This is a full-time hybrid role for a Quality Assurance Specialist at Patient Care Coordination. The Quality Assurance Specialist will be responsible for quality control, quality assurance, quality management, and other QA related tasks. They will also conduct quality audits to ensure compliance with regulatory standards. This role would also incorporate Participant Satisfaction Surveys, NCQA Review and Measures, HEDIS, and other quality metric management as needed.
Qualifications
- Quality Assurance, Quality Control, and Quality Management skills
- Experience in Quality and Compliance Management
- Clinical Experience Required within a healthcare setting
- Ability to perform quality auditing and outcomes
- Excellent attention to detail and analytical skills
- Strong communication and teamwork abilities
- Knowledge of regulatory standards in healthcare
- Experience in Managed Care and Related is Required
- Knowledge in CHC and Service Coordination, specifically in working with Keystone First CHC, AmeriHealth Caritas CHC, PA Health and Wellness and UPMC Healthchoices
Education Requirements
- Bachelor's degree required, Master's preferred
- CCM Preferred, but not required
- LPN will be considered but must be combined with a relevant Bachelor's Degree and credible experience for no less than 3-4 years in a clinical setting with proven record of success
- Bachelor's Degree in Social Work, Nursing, or Related
