DescriptionSHIFT: No Weekends
Position Summary: As Quality Care Coordinator, you will provide population outreach and quality metrics support for primary care physicians and the nurse consultants within the VCP network. This support will include, but not limited to, monitoring of progress towards network goals, gap management, reviewing medical record data/chart reviews to close gaps in care, transitions of care for identified populations, and care coordination to drive quality and cost outcomes for the attributed populations.
Review patients’ data including clinical/claims history, outpatient treatments, medications, electronic medical records, chart reviews or other information to assist in monitoring and facilitation of approved standards of care.
Assist with coordination of care/services as well as care transitions working with both internal and external entities
Analyze documentation and submit appropriate metric and reporting for Quality programs.
Conduct patient outreach to coordinate care for preventative and chronic disease management services to complete gaps in care.
Interacts with other departments to ensure the smooth transfer of member information across the continuum of care
Works closely with primary care offices either onsite or remotely to help provide support in managing the patient population including working and analyzing reports, identify opportunities for improvement, contacting patients via phone, mail or other means.
Assist with referring to appropriate ancillary services such as payer specific CM/DM programs, BH resources, pharmacist support, and other resources as identified.
Assist assigned practices with managing their populations that can include, but not limited to, specific chronic diseases, high ER utilizers, medication compliance, and other identified areas of focus.
Monitor practice progress on an ongoing basis, which may include analysis of data and identifying opportunities for improvement.
Identifies problematic issues, determines reasons and actions taken to resolve, and escalates appropriately
Builds rapport and establishes credibility with the physician leadership and members.
Knowledge of primary care practice process preferred
Experience with evaluating and monitoring data around quality metrics preferred.
Knowledge, Skills, & Abilities
Proficiency with MS Word, Excel, and Power Point required.
Adaptability – Maintaining effectiveness when experiencing major changes in work tasks or the work environment; adjusting effectively to work within new work structures, processes, requirements, or cultures.
Energy – Consistently maintaining high levels of activity or productivity; operating with vigor, effectiveness, and determination over extended periods of time
Managing Conflict – Dealing effectively with others in an antagonistic situation; using appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
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For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.
For questions about your job application or this site, please contact:
HCAhrAnswers at 1-844-422-5627 option 1.