Covenant Health

Coordinator - Quality and Care Management, Quality Management

Full Time, 80 Hours Per Pay Period, Day Shift

About Us

Covenant Medical Group employs or manages healthcare clinics of almost every medical specialty – from primary care and walk-in clinics to cardiology, neurology, and more! Our clinics span East Tennessee and the Cumberland Plateau so that medical care is close to home – ensuring you get the right care at the right time and place. We’re a proud member of Covenant Health!

Position Summary:

The Coordinator of Quality and Care Coordination Services is responsible for the integration of the financial, clinical, and quality functions of Quality and Care Coordination under the supervision of the Manager of Quality Initiatives. The Coordinator, in collaboration with the manager is a leader, innovator and change agent in pursuit of seamless care of the patient across the continuum. The Coordinator of Quality and Care Coordination Services promotes patient care continuity and quality through collaborative processes, evidenced based practice and quality improvement activities. The Coordinator actively seeks opportunities to identify and implement best practices using a multidisciplinary approach. The scope of practice encompasses the use of quality improvement principles and care management processes in pursuit of improved outcomes. The duties and responsibilities of this position are coordination of activities within the Quality Department, as well as managing the department in the absence of the Manager.

Recruiter: Sandra Simmons || apply@covhlth.com

• Serves as expert in performance improvement principles.
• Identifies opportunities for improvement in Quality and Care Management.
• Analyzes data to detect concerns and implements actions to improve variances.
• Evaluates actions to ensure improvement and continues to monitor performance for sustained progress.
• Actively participates in medical staff peer review activities as directed.
• Assists in the design and implementation of evidenced based care in collaboration with providers and other members of the health care team.
• Assists care coordinators in monitoring Quality Measures and other department metrics.
• Oversees daily operations to maintain continuity of Care Coordination Processes.
• Collaborates with clinical team, Quality Manager, Care Coordinators and other health care professionals in the establishment of measureable metrics to determine improved patient outcomes.
• Maintains current knowledge of patient satisfaction results and implements actions to improve.
• Collaborates and communicates effectively with the Care Coordinators, providers and other members of the health care team. Attends meetings to disseminate data and data analysis.
• Serves as a resource to Care Coordinators in monitoring Medicare Advantage patients for continued stay criteria.
• Identifies and communicates variances in resource utilization to the appropriate member(s) of the health care team.
• Maintains current knowledge of Payer metrics and requirements and educates staff, providers and multidisciplinary staff members as needed. Provides an executive summary to the manager of any new regulations, operational changes or education needs.
• Assists the Manager in the preparation and dissemination of reports to appropriate stakeholders.
• Assists the Manager with preparation of the monthly Scorecards. Presents the data at stakeholder meetings and other venues, as required.
• Serves as a Liaison between Quality Manager and Care Coordinators.
• Tracks data related to Performance Improvement activities; assists with analysis of the data reports trends and variances for Manager and Care Coordination staff.
• Serves as a resource to Quality and Care Coordination staff to identify and implement actions to mitigate negative outcomes.
• Assists the Manager as a clinical resource for CDI staff for documentation improvement program.
• Identifies educational needs and recommends and assists in education of medical staff, nursing and other staff concerning care coordination products/objectives/methods, which may include, but not limited to, length of stay, resource utilization, ED utilization and reimbursement issues.
• Participates as an active member of committees and teams as requested.
• Ensures that a strong relationship between all disciplines continues to grow with positive feedback for effective decisions.
• Serves as a Care Coordinator when necessary.
• Assists with planning, developing and delivery of educational materials.
• Seeks the most efficient, cost-effective ways to provide appropriate care.
• Ensures multidisciplinary processes are completed and attended by the appropriate care givers.
• Participates in the recruitment, interviewing and orientation of Care Coordination staff.
• Oversees new employee orientation and annual competency in Quality/Care Coordination.
• Assists with development of and updates to policies and procedures.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education :          

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:         

Three (3) years of experience in case management or care coordination with proven expertise in principles of quality and care management.

Licensure Requirement:      

Current Tennessee RN License.  Current certification in Case Management (CCM), Certification in Quality (CPHQ) or Case Management (ACMA) is preferred but not required. Certification in CCM, CPHQ or ACMA preferred within 18 months of hire.