Quality Metric and Care Coordination Manager
Job Summary: The Quality Metric and Care Coordination Manager ("Manager") is responsible for care ensuring clinical metric data is collected. The Manager is also responsible for completing the coordination of care for patients seeing UT Market providers who are paneled with the various payers. This is completed either through direct contact with patients or assuring the medical assistants/office staff are completing the needed steps to close identified gaps. This manager coordinates the comprehensive approach to immediate and/or ongoing care of their complicated and/or catastrophic medical illness and assures the clinic network’s providers meet the expectations of the plans/patients. This Manager also documents interactions with or assures document is completed related to clinic care delivery (multiple encounters) that includes, but is not limited to: care plans, progress notes, correspondences, and authorizations. In addition, this individual uses business intelligence and knowledge of payer quality requirements to independently triage patient needs based on the return on investment and clinical cost/benefit. This individual is a member of the clinical leadership team and reports to senior leadership within the UT employed provider network and the IASIS Clinical Operations team.
Ability to read and communicate effective in English.
Additional languages preferred, not required.
Basic computer knowledge.
For physical demands of position, including vision, hearing, repetitive motion and environment, see following description. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.
Amount of Time
up to 1/3
1/3 to ½
2/3 and more
Talk or hear:
Use hands to finger, handle or feel:
Stoop, kneel, crouch or crawl:
Reach with hands and arms:
Taste or smell:
Clinical background required.
Clinical License required (LPN, RCP, RT, MLT, etc.)
1-3 years in a managed care. May accept clinic experience as a case manager or clinic leadership.
3-5 years experience interfacing with patients on care needs required. May accept patient engagement experience.
Knowledge and experience with Microsoft Office products required.
Strong interpersonal communication skills required.
Strong organizational skills required.
High school, GED equivalent required.
Undergraduate degree preferred.
Certified Case Manager, Certified Disease Manager, Certified Professional of Health Quality (or equivalent) preferred.
- Ability to independently develop effective action plans based on current condition(s), data stream analysis or other sources of information.