Salt Lake City UT 84101 170 South Main
Job DescriptionThis position is responsible for the initial non-clinical activities of quality reviews which includes documenting the gaps in information, coordinating the resolution, and the development of notices to the provider in accordance with internal and regulatory requirements. In addition, this position will be responsible for all processes related to critical and adverse incidents which may require timely internal and regulatory reporting. The coordinator will assist the department with other functions such as patient safety reviews, clinical record review process, accreditation and HEDIS needs, and development of process flows.
- Completes non-clinical review of charts and provides initial decision on eligibility; also responsible for reviewing re-assessments.
- Prepares and triages charts ready for review.
- Provides feedback on documentation errors while guiding towards documentation improvement.
- Prepares information used for management presentations and submission to various internal and external customers including but not limited to state regulators, CMS auditors and internal auditors.
- Prepares and sends communications to vendors and/or provider's office in a manner that is clear and actionable.
- Data entry input, as well as documents, tracks and queries data in appropriate reporting tools.
- Organizes and reports data in databases, spreadsheets and graphics.
- Generates standard reports for Quality team as needed.
- Follows the process through to ensure it is completed and/or resolved.
- Assists clinical reviewers with other tasks such as system navigation, as needed.
- Supports team in day to day functions, accreditation activities and ad hoc reporting as required.
General Job Information
Job FamilyQuality Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date10/25/2018
Date Requisition Created10/25/2018
EducationBachelors, GED (Required), High School (Required)
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- Health plan and quality review experience.
- Strong written and verbal communication skills, organization skills, and the ability to handle multiple tasks.
- Ability to work under timelines and meet standards.
- Knowledge of Microsoft Office product suite.
- Ability to learn documentation systems.
- Experience working with total quality improvement with a healthcare background in treatment modalities, psychopharmacology, federal/state regulatory guidelines, performance measurement.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
Top 5 reasons to work at Magellan
Meaningful Work With People Who Care
At Magellan Health you can do meaningful work and feel confident that you matter in an organization that makes a real difference in the world - one that cares deeply and uses its employees’ collective insight as a competitive advantage.Read More
We are Compassionately Curious
Magellan Health is a place where we listen with real empathy. It’s one of our biggest strengths. It helps us to support each other and develop innovative solutions for the fastest growing, most complex areas of healthcare.Read More
We are Better Together
We rely on our innate ability to work as a high-functioning collaborative team to facilitate compassionate care to all of our members. With such interdependency comes trust, challenge and innovation.Read More
We believe work and life should flow together in unison. We offer resources that match your professional development, a culture that welcomes your ideas, and unparalleled flexibility to fit work around your life.Read More
Be your best at Magellan Health. We’re a collective of remarkably motivated and driven professionals. As a team, we’re proud of the high standards we set for each other and we’re continually inspired to do our best work.Read More
When you sayLife @ Magellan
To be the best you have to work with the bestWe hear you