Population Health Quality Compliance Reporting Coordinator

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center the hospital is the home of the Texas Heart® Institute a cardiovascular research and education institution founded in 1962 by Denton A. Cooley MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.

The Quality Compliance & Reporting Coordinator will be responsible for ensuring that the Value Hub adheres to regulatory standards, contract requirements, and internal quality benchmarks. This role involves analyzing compliance
data, preparing detailed reports, and working closely with various departments to maintain and improve compliance and quality standards. This role is responsible for supporting the understanding of local regulatory requirements, completion of local audits, participation in quality committees, and supporting health plan needs and interactions to ensure consistent implementation of contractual obligations between CommonSpirit Health, our payers and our network providers.

ESSENTIAL KEY JOB RESPONSIBILITIES
• Perform quality management activities related to data collection, data review, and report preparation.
• Assist in the reporting of required quality studies to meet local contractual requirements.
• Assist in the compilation, organization, and presentation of various committee and quarterly reports.
• Takes notes to compose meeting minutes, tracks and follows up on actions.
• Maintain the confidentiality of records and reports for both the membership and contract providers.
• Create, design, and maintain educational resources and tools.
• Request, maintain, and organize members’ medical records from contracted providers.
• Ability to create professional documents using proper grammar, punctuation and appropriate reading level.
• Provide support for regular local auditing (e.g., AMP audits) to ensure consistent and ongoing compliance to regulations.
• Maintain in partnership with operational leaders policies and program descriptions to confirm alignment with regulatory body updates.
• Works proactively with leadership to assist in activities related to audits.
• Conducts meetings and schedules appointments as needed for various audits.
• Monitor and ensure compliance with healthcare regulations, standards, and policies (e.g., HIPAA, Joint Commission, CMS).
• Demonstrate Knowledge of or ability to learn CMS, DMHC, and other applicable regulations.

• Maintain accurate and detailed records of quality assurance activities, including patient care audits and compliance checks.
• Prepare and present quality reports to healthcare management and regulatory bodies.
• Ensure that all quality documentation is up-to-date and accessible to relevant stakeholders.
• Executes PHSO quality compliance strategy and delivers on standards set by central function.
• Maintain case files ensuring compliance with all governing regulatory agencies, document status, and resolution outcomes for each case. Maintain database tracking.
• Other duties as assigned.

Required Education and Experience:

• Associates degree or a clinical Certification, such as medical assistant preferred.
• Two or more years experience in an administrative position.
• Experience in quality assurance, compliance, or and/pay-for-performance or similar programs, preferred.
• Experience in creating and manipulating data with spreadsheets and/or databases using Excel, Access or other similar programs and/or applications.

Required Minimum Knowledge, Skills, Abilities and Training:

• Must be attentive to detail, accurate, thorough, and persistent in following through to completion all activities, demonstrating initiative for completing work assignments. Ability to communicate effectively in verbal and written form. A
  self-motivator with the ability to function independently.
• Extensive knowledge of Microsoft Office applications; Excel, Word, Outlook, PowerPoint.
• Statistical analysis and database skills a plus.

Disclosure summary
The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.