DUTIES AND RESPONSIBILITIES:

• Demonstrates and applies knowledge of the principles of targeted population health, quality improvement, value-based care models, and the triple aim in healthcare.
• Contacts and schedules patients for recommended screenings and visits to improve health outcomes and enhance overall clinical quality.
• Tracks patient contacts and outcomes and brainstorms solutions to barriers.
• Provides follow-up on incomplete screenings and develops processes to improve by monitoring care gaps and tracking patient follow through.
• Documents progress and activity notes corresponding to all patient contacts and attempts in the EHR and maintains a system for patient follow up.
• Understands preventive health care and relays the importance of maintaining scheduled appointments for recommended screenings to patients.
• Develops and maintains effective working relationships with PHC's clinical teams, health plan representatives (payors), and other quality improvement stakeholders.
• Familiar with UDS measures and basic interventions for quality improvement.
• Troubleshoots barriers to improvement and works with stakeholders to achieve established goals.
• Uses PDSA (Plan, Do, Study, Act) methodology to test change and improve outcomes.
• Develops knowledge and familiarity with payor systems and databases for patient and population health tracking, pulls data upon request, and reports data as needed.
• Works with EHR colleagues to access baseline data and track change over time.
• Maintains organized and accurate tracking system for population health activities.
• Submits documents and reports in a timely manner as requested/assigned.
• Assists with patient portal enrollment and patient satisfaction activities as needed.
• Ensures all patients are attributed to/empaneled with a Primary Care Provider (PCP).
• Attends staff meetings and meets with the PHS and CQT on a regular basis.
• Supports and adheres to PHC's mission, vision, and values and follows established PHC policy and procedure.
• Understands and is committed to HIPAA and the importance of safeguarding PHI (protected health information).
• Assists when needed in training and orientation of new co-workers.

Women's Health Programs --

• Demonstrates familiarity with women's preventive services, programs for breast and cervical cancer screening, and how they support clinical quality and patient health.
• Ensures eligible patients receive breast and cervical cancer screening services in accordance with the Illinois Breast and Cervical Cancer Program (IBCCP) guidelines and standards of care.
• Supports comprehensive case management for PHC's well women programs.

The above description is a general statement of required major duties and responsibilities performed on a regular and continuous basis. It does not exclude other duties as assigned.

MINIMUM QUALIFICATIONS - To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

• Must be organized with strong attention to detail and able to manage one's own time effectively to complete work as assigned. Produce accurate and timely reports.
• Ability to follow established procedures, think critically, ask questions when needed, and make suggestions for improvement.
• Must deliver outstanding customer service and communicate with patients, colleagues, and other stakeholders with courtesy, professionalism, and respect.
• Ability to navigate electronic health record (EHR) software with skill and commitment to data integrity.
• Must exhibit cultural sensitivity and be accustomed to and comfortable with working in an inclusive environment and with a diverse patient population.
• Ability to positively interact with other staff and stakeholders in a fast-paced environment, and sometimes under pressure.
• Possess initiative, flexibility, and the ability to effectively work as part of a team.
• Ability to perform multiple, simultaneous, and occasionally complex tasks to achieve desired results.
• Must be a team player with the ability to work on assigned initiatives independently and with minimal supervision.
• Ability to adapt to changing work environment and duties as needed/assigned.

EDUCATION/EXPERIENCE REQUIREMENTS:

• Minimum of one year of experience working in a Federally Qualified Health Center (FQHC) with previous NextGen EHR experience required.
• Previous experience with population health and/or clinical quality improvement preferred.
• Requires a high level of computer proficiency, including MS Office Suite (Outlook, Word, Excel, PowerPoint, etc.) and other computer/EHR software as needed.
• Degree in a healthcare related field preferred but not required.

Completed background check and drug screen required prior to start date.