Clinical Quality Consultant

Clinical Quality Consultants   

Iowa Total Care’s primary quality goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving the quality of care and services delivered. We are focused on collaborating with providers to generate positive member health outcomes, improved population health, and ensuring our members are receiving the highest level of quality care.

Clinical Quality Consultants Program  

Our comprehensive Quality Program addresses both the quality and safety of clinical care and quality of services provided to your patients, our members. To assist you in providing quality health outcomes, Iowa Total Care has developed an innovative Clinical Quality Consultant (CQC) Program, which is led by Clinical Quality Consultants.

CQC consists of a diverse team of registered nurses who will serve as your individual point of contact. They will assist in the education and management of clinical requirements that are part of Risk Adjustment, HEDIS®, State and CMS regulatory requirements, and other quality measures.  Onsite visits will be scheduled to answer quality questions, discuss member care successes and opportunities, address quality concerns and review Clinical Quality Summary reports and scorecards.

Your  CQC  will  also  complete  medical  record  reviews  throughout  the  year  to  help  you  improve  quality  measure  rates,  ensure  complete  coding  and  documentation,  and  identify  documentation  strengths  and  opportunities. A review of processes will be conducted to promote effective coordination and continuity of care.

Please refer to the links below for additional information regarding the Clinical Quality Consultant program.

• Iowa Total Care Provider Clinical Quality Consultant Program (PDF)
• Iowa Total Care Provider Clinical Quality Consultant Outreach Plan (PDF)
• Iowa Total Care Clinical Quality Consultant Territory Map (PDF)