Medical Quality Improvement Coordinator

Overview

This is a specialized role requiring direct experience in Medical Quality Improvement (QI). Candidates must have a proven track record of managing HEDIS measures and closing care gaps, while maintaining high standards in remote front-office operations.

Schedule:

• Monday - Friday, Specific hours are to be determined within the clients business hours, Pacific time (40 work hours per week)

Responsibilities

Quality Improvement Support

• Track and report care gaps, HEDIS measures, and Chart Audits
• Support QI initiatives by assisting with chart audits, care plan reviews, and compliance checklists
• Communicate with providers and case managers to ensure documentation accuracy and care gaps are being addressed
• Assist with referrals, authorizations, and coordination of specialty services

Receptionist Duties

• Answer incoming calls, route messages, and manage ULTATEL TEXT Message systems professionally
• Schedule appointments, transportation, and follow-up on GA food requested
• Provide courteous, bilingual communication to members and providers
• Maintain accurate documentation in SwyftOps systems and ensure timely data entry

Program Knowledge

• Understand the companys Enhanced Care Management (ECM) model, including eligibility, referral workflows, and service offerings
• Support member onboarding by explaining ECM benefits, care coordination goals, and available resources in both English and Spanish
• Assist with Outreach & Referral (OR) processes, ensuring timely follow-up and accurate documentation of member engagement
• Maintain working knowledge of Medi-Cal guidelines, CalAIM initiatives, and the companys interdisciplinary care approach
• Participate in ongoing training to stay current on program updates, compliance standards, and QI metrics

Requirements

• QUALITY IMPROVEMENT EXPERIENCE IS A MUST: Minimum 2 years of experience in medical reception, care coordination, QI support (required)
• Fluent in English (Spanish and Mandarin are a plus)
• Basic understanding of medical terminology and healthcare services
• Proficient in EMR systems, Microsoft Teams, Excel, and remote communication tools
• Strong understanding of HIPAA, HEDIS, and MEDI-CAL documentation standards
• Exceptional organizational skills and attention to detail
• Ability to work independently while maintaining accountability and productivity

Qualifications

• High school diploma required; Associate degree in Business Administration, Healthcare, or related field preferred

Technical & Environmental Requirements

• Reliable high-speed internet connection
• Secure workstation with proper lighting, ventilation, and minimal noise
• Access to locked file storage and password-protected devices
• Willingness to comply with the companys IT and security protocols

Independent Contractor Perks

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage for eligible locations

Note

• Please click the Apply button to complete your application, including the assessment questions, technical check, and voice recording. As this is an Independent Contractor role, candidates are responsible for their own taxes. Professional fees are determined by your application performance, and fully completed profiles will receive priority review.

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