Population Health Specialist

DUTIES, RESPONSIBILITIES, AND PERFORMANCE CRITERIA:

• Creates and reviews reports to aid the physicians with RAFing.
• Creates and reviews reports and audit charts to aid the physicians in closing gaps in supplemental screenings
• Creates and reviews metric reports and audit charts to aid in the collection of STARS quality-related data
• Review patient charts, and if various measures have been done, submit information to the delegated entity
• Evaluates reports to identify physician and office trends, including weekly and monthly reporting.
• Trains the physicians and clinical staff on various pieces of equipment used in the Medicare Advantage program.
• Performs quality checks on the technique used by the clinical staff while performing testing using various pieces of equipment utilized in the Medicare Advantage program.
• Provides clerical and/or administrative support to clinical staff and managers for special studies, projects, and reports related to value programs.
• Conducts inbound and outbound calls for program requirements, including, but not limited to: patient scheduling, surveys/screenings, reminder calls, census management, and distribution of materials to appropriate clinical personnel or patients.
• Assembles and mails various educational materials, supplies, and medical equipment to patients and clinical staff based on need and direction from physicians.
• Facilitate monthly meetings with physicians and staff as necessary
• Facilitate weekly rounding meetings with physicians and staff as necessary
• Ability and willingness to work flexible hours to meet staffing needs.
• Ability and willingness to travel to the assigned offices
• Creates action plans and implements the actions for low-performing physicians
• Implementation and go-live support for new physicians
• Workgroup attendance, agenda, and minutes as assigned
• Distribution and training on value-based program reporting
• Call and assist patients on behalf of the specialist-assigned value-based program to ensure metrics are met for value-based programs
• Professionally handles confidential data.
• Possesses the ability to organize, assess, delegate, and communicate effectively with team members.
• Accepts other duties as required, willingly. Demonstrates follow-through on assigned duties.
• Relies on experience and demonstrates good judgment to plan and accomplish goals.
• Completes assignments in a timely manner.
• Utilizes available resources effectively. Seeks assistance or direction when uncertain or unfamiliar with operations or procedures.
• Requires minimal supervision.
• Serves as a role model to all patients and staff. Displays a positive attitude and fosters a team spirit within the offices. Have good employee relations skills.
• Demonstrates �Customer Service� skills to patients, families, physicians, referral sources, and all staff, by treating everyone with courtesy, concern, respect, and sensitivity.
• Communicates effectively with patients, visitors, staff, physicians, and other company personnel.

EDUCATION AND JOB REQUIREMENTS:

• High School diploma or general equivalency
• Clinical or office manager / leadership preferred
• Knowledge of medical terminology and procedures, ICD-10 and CPT coding, and insurance processes
• MS Office literacy, including Intermediate Excel skills
• Five plus years of previous experience in a physician practice and/or a Medicare Advantage Program
• Excellent organizational skills
• Strong interpersonal skills
• Good verbal and written communication skills