Administrative Coordinator – Quality

<p><strong>Are you looking for a career filled with purpose and opportunity?</strong></p> <p><strong>By joining Region 10, you can help actualize our mission of promoting opportunities for recovery, discovery, health and independence for individuals receiving services through ease of access, high quality of care and best value.&nbsp; View the details below on how you can become an Administrative Coordinator &ndash; Quality for Region 10 PIHP</strong></p>

Port Huron, MI

Region 10 PIHP

<p>Region 10 Prepaid Inpatient Health Plan Provides public services for mental health and substance use disorders through the Community Mental Health agencies in Genesee, Lapeer, Sanilac and St. Clair counties and a panel of other care providers.</p> <h4>Mission: Promoting opportunities for Recovery, Discovery, Health and Independence for individuals receiving services through ease of access, high quality of care and best value.</h4>

keywords: role summary,analysis,reporting,support,quality assurance,claims,experience,knowledge,consulting,flexibility,education,preferred qualifications



Overview: <p>An employee at this level is required to perform some or all of the following duties, which do not include all tasks to be performed:</p> <ul> <li>Coordinate / oversee Healthcare Integration initiatives for region</li> <li>Develop needed systems and processes to ensure annual State performance bonus requirements related to care coordination are addressed</li> <li>Identify shared members for care coordination plans via CC360</li> </ul>
Responsibilities: <ul> <li>Schedule / facilitate care coordination meetings with MHP, PIHP, CMH for selected shared members</li> <li>Liaison with Medicaid Health Plans</li> <li>Create, update, and close (as needed) care coordination plans in CC360 for selected members</li> <li>Weekly FUH reports &ndash; review / submission</li> <li>Review / analysis of CC360 data reports on performance measures</li> <li>Development of PBIP reports per MDHHS contract requirements</li> <li>Review / analysis / data validation for performance metrics</li> <li>Development / analysis of outcome reports measuring improvement to population health</li> <li>Provide reports and updates on state performance bonus requirements and Integration project as requested &ndash; Management Team, PIHP CEO, Board, standing committees, etc.</li> <li>Represents Region 10 at state meetings such as PIHP/MHP Workgroup, Shared Metrics Workgroup, MI HIN workgroups (MOAC, etc.)</li> <li>Member of Quality Management Committee</li> <li>Assist with PIP project &ndash; data collection / analysis / review</li> <li>Assist with Coordination of External Quality Reviews and other site reviews as applicable</li> <li>Claims Verification processes &ndash; ensure required percentage of Medicaid claims are reviewed annually for accuracy, verification of service provision, etc.</li> <li>Policy and Procedure review</li> <li>Contract monitoring &ndash; SME review</li> <li>Other tasks as assigned</li> </ul>
Requirements: <strong>Minimum Qualifications</strong><br /> <ul> <li>Bachelor&rsquo;s Degree in behavioral health field</li> <li>Experience working at Pre-Paid Inpatient Health Plan (PIHP) and/or Community Mental Health (CMH) and/or in Healthcare field</li> <li>Experience in the area of Quality Management</li> <li>Experience in writing reports, analyzing data and administrative projects</li> <li>Ability to be a &ldquo;work leader&rdquo; (of a person or function), or advise others</li> <li>Experience in managing projects and teams</li> <li>Advanced knowledge of Microsoft Word and Excel</li> <li>Basic knowledge of Microsoft PowerPoint</li> <li>Ability to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoided</li> <li>Ingenuity is required to adapt, alter or improvise alternatives when unexpected situations occur</li> <li>Ability to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcome</li> <li>Ability to use or exert influence in a work process</li> <li>Ability to provide, exchange and explain information which conveys an opinion or evaluation of the facts or analyses</li> <li>Ability to develop and/or maintain effective work relationships with new, established or non-receptive individuals/organizations through tact, diplomacy and persuasion</li> <li>Valid State of Michigan Driver&rsquo;s License</li> <li>Must have access to transportation</li> </ul> <strong>Preferred Qualifications</strong><br /> <ul> <li>Master&rsquo;s Degree in behavioral health field</li> <li>Experience working in Physical Healthcare field</li> <li>Experience with data reporting / analysis / validation</li> <li>Experience / knowledge of statistical analysis</li> <li>Basic knowledge of MDHHS reporting</li> <li>Knowledge of State of Michigan Medicaid Provider Manual</li> </ul>