Clinical Quality & Health Services Coordinator Job 2024 Full Time

Clinical Quality & Health Services Coordinator

– (2400398)

This is a remote position in Ohio. Note, ad-hoc/situational on-site requirement in Brooklyn, Ohio. Ohio candidates preferred.

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Responsibilities

Provides departmental administrative support as follows:

• Processes and troubleshoots vendor invoices, and purchasing, finance, and legal requests for contract implementation, renewals, payments, and budget variances.

• Requests and tracks medical records from providers. Scans, indexes, and updates records into document management and medical record systems.

• Updates and maintains policies and procedures on SharePoint site.

• Assists with the planning, execution, and monitoring of departmental projects and initiatives. Tracks project timelines and ensure deadlines are met.

• Prepares, edits, and distributes various documents, reports, and correspondence. Maintain organized records and filing systems.

• Manages and responds to departmental voicemail and e-mail work queue inquiries or issues related to programs and initiatives such as Medicare Advantage, HEDIS and NCQA or other clinical quality programming. Responds via verbal and written communications to Company employees, members, providers and/or vendors. Trouble shoots issues and makes process improvement recommendations.

• Supports quality committees by preparing agendas, compiling documents, recording minutes, and confirming attendance. Drafts minutes assuring format required by NCQA. Attends prep meetings with committee chair. Schedules and coordinates meetings in Outlook, and arranges for remote technology, catering and facility needs.

• Performs data entry into databases and/or spreadsheets. Runs or creates reports from databases or

• other source materials and provides to management. Reviews and apprises management of any issues.

• Represents the company or division at health fairs, wellness programs or other events. Assists with pre and post event activities.

• Orients, trains, and assists new hire staff with system navigation and access, policies, and procedures, etc. Creates job aids and flowcharts for Clinical Quality Improvement projects.

• Performs other duties as assigned.

Qualifications

Education and Experience

• Associate degree in business or healthcare administration or related field or equivalent combination of training, education and experience.

• 5 years of administrative support or customer service experience in a health plan or healthcare setting.

• Clinical experience a plus.

Technical Skills and Knowledge

• Strong Microsoft Office skills (Word, Excel, PowerPoint, Outlook, Teams) and database reporting skills. Proficiency with document management and delivery systems.

• Knowledge of medical terminology.

• Knowledge of healthcare government programs a plus.

• Knowledge of committee meeting processes including agenda, drafting minutes, and follow up with stakeholders.

• Ability to communicate with internal and external stakeholders such as vendors, members, providers.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That’s why we offer an exceptional package that includes:

A Great Place to Work:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance � insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual�s status as a mutual company means we are owned by our policyholders, not stockholders, so we don�t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There�s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We�re not just one of the largest health insurance companies based in Ohio, we�re also the longest running. Founded in 1934, we�re proud of our rich history with the communities where we live and work.

At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.