Clinical Quality Project Coordinator

HF Management Services, LLC (Healthfirst) is hiring a Clinical Quality Project Coordinator to coordinate medical record retrieval and ensure requests are completed accurately and on time. The role tracks and follows up on requests, performs quality checks, resolves retrieval barriers, and supports supplemental data submissions in collaboration with internal teams, providers, and vendors.

Responsibilities

• Coordinates medical record retrieval activities from provider offices, hospitals, clinics, and other healthcare facilities, including in-person/on-site retrievals as required
• Submits, tracks, and monitors medical record requests through approved retrieval methods and maintain accurate documentation of request status and activity
• Conducts timely follow-up on outstanding requests and work with provider contacts to resolve barriers impacting record retrieval; escalate unresolved issues as appropriate
• Performs quality checks of received medical records to ensure documentation is complete, accurate, legible, and responsive to the request; proactively follow up on incomplete or missing records
• Utilizes internal systems, electronic medical records, provider portals, Microsoft Excel, and other approved tools to track, reconcile, and report retrieval activity
• Provides status updates on retrieval progress, outstanding requests, barriers, and completion rates to management and project stakeholders
• Maintains confidentiality and handle medical records and protected health information in accordance with Healthfirst policies and applicable privacy and security requirements
• Meets established productivity, quality, accuracy, and turnaround-time expectations
• Supports designated team supplemental data training and submission reconciliation activities for providers and vendors as required
• Participates in required meetings, training, and project activities. Performs additional duties as necessary and as directed

Preferred

• Associate's degree or higher from an accredited institution
• Prior experience in Managed Care/Health Insurance, in a health-related field or environment
• Knowledge of HEDIS/QARR and/or Medicare Stars
• Strong working knowledge of Microsoft Office Suite and Outlook
• Associate’s degree
• higher
• Managed care experience
• Health insurance experience
• Health-related field experience
• HEDIS/QARR knowledge
• Medicare Stars knowledge
• Microsoft Office Suite
• Microsoft Outlook

Benefits

• Hybrid work location: Remote, office-based, and in the field as needed.
• Medical, dental and vision coverage (subject to eligibility requirements).
• Incentive and recognition programs (subject to eligibility requirements).
• Life insurance (subject to eligibility requirements).
• 401k contributions (subject to eligibility requirements).

Company

• New York health insurer offering Medicaid and Medicare Advantage plans
• New York, New York, USA
• https://healthfirst.org/
• Founded in 1993
• 1001-5000 employees

Qualifications

• HS diploma or GED from an accredited institution
• Ability to travel around the NYC metro area (five boroughs) and Long Island as necessary
• Associate's degree or higher from an accredited institution
• Prior experience in Managed Care/Health Insurance, in a health-related field or environment
• Knowledge of HEDIS/QARR and/or Medicare Stars
• Strong working knowledge of Microsoft Office Suite and Outlook

Required skills

• HEDIS/QARR, Health Insurance, Managed Care, Medicare Stars, Microsoft Office Suite, Microsoft Outlook

Preferred skills

• Associate's degree or higher from an accredited institution, Knowledge of HEDIS/QARR and/or Medicare Stars

Experience

• Entry level