Clinical Quality Coordinator
Listed on 2026-08-06
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Nursing
Clinical Quality Coordinator
Location: El Segundo, CA
Remote Status: Hybrid (3 days in office, 2 days remote)
Job : 609
The RoleThe Clinical Quality Coordinator coordinates and executes clinical performance initiatives that advance the company’s mission to deliver quality care to seniors.
Working under the direction of the Director of Clinical Performance, this position collaborates with clinical and operational care teams to drive quality of care, surface & close care gaps, and support effective care management of our senior population.
Key success factors include strong organizational and communication skills, tactical problem‑solving, the ability to manage multiple work streams simultaneously, and a commitment to high‑quality work in a fast‑moving environment.
Key Responsibilities- Ensure new patient charts are prepared, accurate, and complete prior to each patient’s first visit by reviewing and integrating data from available medical records and external sources.
- Review and reconcile clinical information including allergies, diagnoses, medications, vaccines, and relevant history using established protocols and standards.
- Ensure relevant diagnoses are presented in appropriate chart sections to support risk adjustment review by the clinical team.
- Document relevant family, surgical, and procedure history to support comprehensive, whole‑person care.
- Support HEDIS measure performance by reviewing and documenting applicable screening and preventive care history for assigned patient populations.
- Identify, surface, and address quality measures through population health tools and/or supplemental file submissions.
- Support claims review and gap closure coordination across payor and provider channels.
- Review patient quality, risk adjustment, and admissions data to identify patients requiring outreach or follow‑up.
- Update population health tracking tools to maintain an accurate, real‑time view of care gaps and outreach status.
- Monitor health information exchange notifications and community alerts for ED visits and inpatient admissions; initiate transitions‑of‑care workflows as appropriate.
- Retrieve and reconcile clinical documentation from hospitals and outside facilities to ensure accuracy and continuity of care in patient charts.
- Ensure all program activities adhere to applicable regulations, organizational standards, and payor requirements.
- Maintain accurate documentation in the EHR and population health platforms to support audit readiness and quality reporting.
Education
- Bachelor’s degree in Healthcare Administration, Public Health, or a related field (required).
Experience
- 3+ years of experience in program coordination, care management, health information, or a related healthcare role (required).
- Preferred:
Experience in value‑based care, managed care, or a primary care setting; background in HEDIS, risk adjustment, or population health programs. - Excellent written and verbal communication skills; comfortable presenting to and meeting with clinical teams.
- Familiarity with navigating EHR systems and retrieving & reconciling outside records from health information platforms (HIEs, payer data feeds, lab/Imaging portals, etc.); experience with ambulatory or primary care environments preferred.
- Comfort with AI‑assisted tools, population health platforms, and technology‑forward workflows.
- Proficiency in Microsoft Office tools.
- Knowledge of HEDIS measures, HCC/risk adjustment concepts, or payor operations preferred.
- Professional demeanor with the ability to work effectively across functions and at all levels of the organization.
Lunch and parking provided every day in office.
Competitive Compensation Package. Recognize valuable contributions and ensure financial security.
Comprehensive Medical, Dental, and Vision Benefits. Prioritize health and well‑being.
Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) available.
Paid Time Off. Enjoy paid holidays, vacation time, and paid parental leave.
401K Program with Company Match. Plan for future with company match.
Monthly Phone/Internet Reimbursement. Stay connected.
Comprehensive Life and AD&D Coverage. 100% premiums covered by GGH for Basic Life and accidental death & dismemberment insurance for full‑time team members; voluntary supplemental life insurance offered at discounted rate.
Short‑Term Disability Coverage. Voluntary short‑term disability provides a percentage of salary during periods of illness or injury.
Collaborative and Supportive Community. Join a supportive community with dedicated care coordinators and MD advisors.
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