Opening
Full Time 40 hours URCC 204 Ambulatory Medicine
Schedule
7 AM - 6 PM
Responsibilities
POSITION SUMMARY:
HYBRID Office/Home
This role may have the option to work a Hybrid-remote schedule. Must demonstrate the ability to cultivate team based care in a professional and positive manner by using both effective verbal and written communications, regardless of work location
This position is responsible for primary care population health management and performance improvement of clinical quality metrics such as breast cancer screening, colon cancer screening, diabetes management, hypertension management, pediatric well child checks, lead screenings, and immunizations. Provides ongoing data collection, tracking/monitoring, analysis, reporting and outreach on these key benchmarks. Offers data-driven support for operational efforts related to payer contracts, provider compensation incentives, and overall population health tied to improving these metrics. Collaborates with practice teams on quality and process improvement initiatives by compiling and reporting data trends on quality projects focused on moving these clinical care measures. Leads practice teams in quality and process improvement initiatives Supports these initiatives with collection and reporting of data trends in quality initiatives. Supports data analytics supervisor with development, testing and education for implementation projects for data coordinators and other staff as appropriate. Assists in onboarding, training, mentor new coordinators.
TYPICAL DUTIES:
- Comprehensive Data Tracking & Monitoring
- Independently analyzes several clinical metric dashboards and practice progress through identifying trends, patterns, or sudden compliance changes based on autonomous data interpretation and evaluation.
- Independently generates, maintains, and delivers clinical quality metric reports for provider’s quality metric performance. Exercises individual discretion by proactively reporting any data integrity issues noticed through ongoing chart reviews.
- Drives successful patient outcomes in alignment with valued based contracts. Supports provider performance for clinical quality metrics by maintaining accurate records, providing documentation and performing patient outreach through the gap closure management process.
- Propels accurate provider patient panel management by conducting direct outreach to active vs inactive patients to: confirm if they still consider the practice their main provider and need to reestablish care after time away, or determine if they now see other primary care providers necessitating documentation updates in their medical records for accurate reflection of their full care team across systems.
- Population Health Management
- Performs comprehensive pre-visit planning by independently reconciling individual patient charts in eRecord, utilizing various portals and databases to ensure charts are up-to-date before appointments. This includes identifying any missing test results, exams, or other clinical data and retrieving outstanding records to complete chart documentation. Leverages strong working knowledge of EMR and other systems to efficiently gather necessary pre-visit information.
- Autonomously supports providers by placing orders or referrals, (per protocol) to review and approve for the clinical quality metrics regarding preventive care and chronic care management.
- Serves as main liaison between specialty provider offices or imaging and the primary care providers regarding care coordination and follow-up care for patients.
- May independently coordinate or schedule primary care provider appointments for patients to receive medical services for preventive care and chronic care management based on individual assessment.
- Gap Closure Management
- Independently identifies gaps in care by proactively reviewing patient records to determine missing preventative, chronic, or follow up care across patient populations clinical quality metrics. Performs comprehensive outreach through various modalities including but not limited to, phone calls, letters, and/or patient portal messages.
- Leverages analytical reports and dashboards to closely monitor outstanding quality health care metrics and measure progress.
- Serves as main driver of quality improvement/gap closure for patient population by taking accountability to improve benchmark metric performance.
- Project Management
- Partners with population health leadership and peers across practices to ideate innovative workflows, care coordination processes and procedural enhancements focused on elevating practice-level population health initiatives. Takes ownership in piloting small-scale workflow modifications directly within assigned practice(s) to empirically test effectiveness before presenting data-backed recommendations to champion wider change adoption across the broader Primary Care Network.
- Designs and validates enhanced processes for achieving clinical quality metrics aligned to value-based contracts. Leads implementation efforts to scale validated processes across the broader population health team.
- Provides complete work coverage for fellow care coordination staff out on extended leaves at any practice within the Primary Care Network. Serves as primary back-up for peer roles to independently manage all daily responsibilities and time-sensitive deliverables across assigned practice(s), ensuring no drop-off in population health support during peer extended leaves.
- Exercises individual discretion in identifying and completing value-add projects that evaluate reporting, dashboard metrics, and processes to elevate population health. Continually expands EMR and systems knowledge to advance initiatives and smoothly cover workflows network-wide.
- Maintain a high level of knowledge of functional operations of the medical record to advance population health initiatives and overall workflows.
- Collaborates with Primary Care Administration to train new staff through hands-on learning and workflow observation. Independently provides continued support to new staff regarding workflows, best practices, and standard procedures.
- Data Entry
- Maintains excellent record keeping of clinical quality metrics for the patients by populating records into the electronic medical record which aids in achieving goals set by incentivized payer contracts and supports provider compensation.
- Independently requests records from specialty provider offices or imaging facilities and follows data entry standards to ensure accurate record keeping for high-quality patient care.
- Takes ownership as co-lead for practice-based teams supporting annual NCQA renewal recognition with the Practice Manager, including independently attending meetings and providing necessary reports to complete renewal application.
- Proactively builds strong working relationships with all practice staff and providers through everyday collaborative interactions. Exercises autonomous judgment in working with staff/faculty to enable high-quality care.
- Identifies and executes best practice workflows, collaborating with the practice team to promote the achievement of high-quality health care metrics. Works in partnership with providers to determine action plans for performance improvement based on own data-driven recommendations.
QUALIFICATIONS:
- A.A.S. degree required
- B.S. or B.A. degree preferred
- 3 years’ experience in a professional office environment, including 1-3 years clinical, operational, quality data collection and reporting experience required
- Or equivalent combination of education and experience required;
- Excellent time management, interpersonal, communication, and organizational skills with attention to detail and ability to work independently. Ability to interface effectively with a broad array of individuals including but not limited to patients, providers, nurses, managers, and other staff required.
NOTE: This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range
Pay Range: $19.08 - $25.77 Hourly
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.