Franco Pliego
Ecm Qa Specialist @Pacific Health Group
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WORK HISTORY
Ecm Qa Specialist @Pacific Health Group
Reviewing a sample of ECM participant charts weekly to assess documentation accuracy, completeness, and compliance- Conducting monthly training sessions for ECM care coordinators on recent policy updates and documentation standards- Developing corrective action plans based on audit findings and monitoring follow up actions- Preparing quarterly quality assurance reports that outline audit findings, corrective actions, and ongoing recommendations for ECM leadership- Shadowing care coordinators during member outreach calls to evaluate service quality and real time adherence to scripts- Creating and maintaining a monthly dashboard of key quality metrics (e.g, 72hour outreach completion rate, initial Health Needs Assessment completion rate, closed loop referral rate) and presenting results to the ECM Quality Committee- Leading a focused audit on housing related ECM interventions for members experiencing homelessness and summarizing findings in an improvement brief- Partnering with IT to test and validate new documentation templates in the EHR to ensure all required CalAIM data elements are captured correctly- Conducting root cause analysis on recurring documentation deficiencies and coordinating with team leads to implement preventive solutions.
EDUCATION
Mt. San Antonio College
Associate of Arts - AA, Communication, General
University of California, Riverside
Public Policy, Policy Institutions and Process / Social, Cultural, and Family Policy
ABOUT FRANCO PLIEGO
To operate and coordinate in a highly clerical position, providing support and managing increasingly difficult tasks.
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