Job Description: Description: The Quality Specialist reviews clinically appropriate information as defined by OpTime reports and Surgery Scheduling projects. Maintains database for QI projects. Oversees block time management. Precepts and trains surgery schedulers on all applicable workflows and processes. Assists management with the development and revision of workflows. Monitors productivity of surgery ticket cues by specialty. Trouble shoots complex surgical coordination issues.
Responsible for monitoring the applicable OpTime reports and scheduling cues.
Trains and precepts surgery schedulers to applicable workflows.
Assess instructional effectiveness and determines the impact of training on employee skills.
Partner with internal stakeholders and liaise with experts regarding instructional design.
Implements and gathers performance data regarding QI projects.
Develops reports for leadership.
Tracks quality indicators specific to surgery scheduling.
Builds and makes appropriate adjustments to block time in OpTime.
Activates new providers and procedures in OpTime.
Schedules surgical cases and coordinates care as needed for all surgical specialties.
Assigns appropriate diagnosis and procedure codes following coding guidelines for ICD-9, CPT-4 and HCPCS codes for all internal requests.
Provides verbal notification, in accordance to policy and procedure for members, contracted facilities, and providers with respect to the outcome of surgical procedures.
Responsible for the support of operational activities for the Surgery Scheduling Team.
Interacts with physicians and staff as necessary to gather required information.
Maintains excellent customer service and professionalism with providers and members when executing daily responsibilities.
Maintains department productivity standards and accuracy in data entry.
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Surgery Scheduling Supervisor.
Knowledgeable and compliant with regional and Surgery Scheduling department specific personnel policies and procedures.
Participates in annual regional and departmental compliance training.
Access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform the job.
Demonstrates understanding of HIPAA privacy regulations by maintaining confidentiality of Protected Health Information (PHI).
Demonstrates doing the right thing and doing things the right way is an underlying premise in all work-related activities and is able to identify location of copy of Principles of Responsibility.
Develops and maintains an awareness of how to report compliance issues and concerns. Identifies issues of wrong doing and promptly investigates and reports to immediate supervisor or manager of the department. Assures an atmosphere and culture for staff to report issues of wrong doing.
Demonstrated problem solving skills.
Ability to build effective working relationships with physicians, staff, QRM staff, members, hospitals, surgery centers, vendors, contracted first assist providers and other Kaiser Permanente departments.
Ability to make quick decisions based on available information, take appropriate action and stick to decisions when challenged..
Excellent planning and time management skills including the ability to handle multiple tasks at any given time.
Ability to handle frequent changes.
Ability to deal with interpersonal conflict with a mature attitude.
Other duties as assigned.
Basic Qualifications: Experience
Minimum five (5) years of experience in scheduling specialty appointments, with at least one of which should be from a managed health care delivery setting.
Minimum one (1) year of experience scheduling surgery using OpTime. Education
Associate's Degree or two (2) years of experience in a directly related field.
High School Diploma or General Education Development (GED) required. License, Certification, Registration
Certificate of Completion of course in Medical Terminology required.
Certificate of Completion of course in Project Management required.
Project Management Certificate Program.
Medical Terminology Course.
Substantial clerical and administrative skills.
Proficient in Microsoft office applications including: word, outlook, excel, PowerPoint.
Trained in EPIC ambulatory platform (cadence and OpTime).
Minimum two (2) years minimal surgery scheduling experience in four (4) or more surgical specialty areas.
Administrative background in a clinical setting preferred.
Primary Location: Georgia,Atlanta,Regional Office - 10 Piedmont 10 Piedmont Center Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 7:00 AM Working Hours End: 3:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: UFCW - Local 1996 Job Level: Individual Contributor Job Category: Administration, Clerical and Support Services Department: Rgnl Med Fac-Call Cntr Travel: Yes, 5 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.