Practice Transformation Facilitator

About Care at Home

Company Overview

Care Medical Practice is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to Black and Brown communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patients’ race, culture, and environment is critical to delivering improved health outcomes. By empowering our patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day.

Position Overview

The Practice Transformation Facilitator reports to the Practice Transformation Manager, Care Medical Practice, with accountability for aiding the practice transformation efforts for Care Medical Practice. The Practice Performance Facilitator should embody Care Medical Practice core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At Care Medical Practice, we don’t have patients or customers – we have Family Members.

Key Responsibilities

• The Practice Transformation Facilitator will utilize advanced knowledge, discretion, and judgment to independently support the practice in maximizing available information technology resources to achieve improved Family Member’s outcomes and increased office efficiencies.
• Experience in Value Based Payment and Healthcare Innovations.
• Experience in working with IPAs, and other provider groups/ supporting practice workflows, fulfillment of HEDIS and other quality measures, comfortable presenting to physician practices, sharing data and implementing action plans.
• Obtains and analyzes practice specific cost and quality data and reports for cost of care and quality opportunities and assists practice to target high risk members and gaps in care based on data/reports provided.
• Displays strong time & communication management skills as well as a collaborative care approach ideology.
• Monitor, interpret, and report HEDIS and other quality performance measures, market trends, and initiatives that impact IPA regional performance.
• Drives success in population health performance by guiding care teams (practice staff) towards best practices, identifying gaps both through data and operational observation, by providing feedback, education, and training.
• Deliver progress reports and review with practices and care teams. Assess and document practice progression throughout the transformation process.
• Identify performance gaps from report data and guide care teams towards solutions.
• Identify and prioritize key quality and utilization initiatives critical to success under performance-based programs.
• Coordinates, as appropriate, practice interactions and/or follow-up actions with other Care Medical Practice functional areas, including, but not limited to, Network Management/Provider Relations, Medical Economics, and Health Home.
• Works closely with appropriate company resources for (Medicaid VBP, Medicare ACO and Health Homes) to monitor and report metrics such as resource utilization, patient satisfaction, and other key performance indicators.
• Assists in identifying opportunities for improvement within the region's sites and brings forward proposals incorporating solutions to improve efficiency and reduce expenses.
• Works with other third-party organizations such as health plans to resolve operational and roster issues.
• Serves as a liaison with Care Medical Practice Management to facilitate processes between the organization and the practice, creates and hosts tailored learning opportunities to support the deployment of program interventions, use of Care Medical Practice's support tools and other data resources, and provides technical support for such tools, as required.
• Assist with the design, development, and implementation of Care Medical Practice community learning forums.
• Build trust-based relationships with practices and care teams to facilitate change management, engagement, solutioning, and sustainability of population health initiatives.
• Registry and enrollment functionality, including DCE voluntary alignment activities.
• Coordinate patient care by directing the most appropriate specialist or ancillary provider.
• Participate in Daily Hospital Census Rounds forum to discuss the patient’s inpatient status, anticipated discharge and create a post discharge care plan in conjunction with the PHN, Nurse Case Manager and PCP, leveraging others in the Care Team as required.
• Work with our medical providers, consulting the primary care provider for input, and refer the patient to that provider in real time whenever appropriate.
• Offer patient education when appropriate.
• Perform other job-related as assigned.

Required Qualifications

Education/Experience:

• AAS/AS minimum. BA/BS or master’s in healthcare related field preferred.
• Experience with analytical skills and data analysis plus experience is HEDIS/STARS at the practice level.
• Coursework or experience in Quality Improvement, and/or facilitation skills preferred. Qualified experience in healthcare settings preferred.
• The ideal candidate will have had experience in a primary care practice that successfully implemented quality improvement initiatives and Value Base Payment methodology.

Computer Knowledge:

• Excellent computer skills required particularly related to Microsoft applications including Word, Excel, PowerPoint, and Outlook.
• Willingness required to explore and learn new or unfamiliar applications and databases, and when prepared to teach practices and team members how to maximize technology.
• Knowledge of statistical software and other analytic software preferred.
• Microsoft suite of applications with exemplary Excel/spreadsheet skills.

Essential Responsibilities

• Collaboration: The Practice Transformation Facilitator will work closely with other business divisions to learn their needs, internalize their knowledge, and assist with solutions to achieve the business objectives of Care Medical Practice.
• Knowledge: The Practice Transformation Facilitator requires strong interpersonal communication skills, excellent verbal. written, presentation, skills. Ability required to interact with multiple facilities, staff, and community partners.
• Culture: The Practice Transformation Facilitator is accountable for creating a productive, collaborative, safe and inclusive work environment as part of the larger Company.
• Entrepreneurial: Care Medical Practice seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring Care Medical Practice is positioned to innovatively deliver on its promise.
• Communication: Excellent verbal, written communication, and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to Care Medical Practice's team, investors, partners, and other stakeholders.
• Relationships: Ability to build and effectively manage relationships with business leaders and external constituents.
• Culture: Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company.

Benefits

Financial Well-being

• Competitive Compensation: We offer competitive salaries to attract and retain the best talent.
• 401(k) with Employer Match: Plan for your future with our 401(k) plan and a generous 4% employer match.

Health and Wellness

• Comprehensive Medical Plan: We proudly offer the Highmark BCBS plan with an 85% employer contribution, covering your entire family.
• Dental & Vision Coverage: Maintain your oral and eye health with our employer-paid dental and vision plans via MetLife.
• Employer-Paid Insurance: Life, Short-Term Disability (STD), and Long-Term Disability (LTD) insurance are provided at no cost to you.
• Generous Paid Time Off: Enjoy ample time off for rest and rejuvenation with generous PTO, holidays, and wellness time.

Additional Perks

• Continuing Medical Education (CME) Allowance: Stay at the forefront of your field with our CME allowance.
• Commuter Benefits: Save on your commute with our commuter benefits program.
• Mileage Reimbursement: Get reimbursed for work-related travel expenses.

Physical Requirements

Work Environment and Physical Expectations: This role takes you into the heart of the action, working directly with clients and communities in dynamic settings. Whether in-home, assisted living, or community environments, you’ll make a tangible difference in people’s lives while enjoying the variety and flexibility of fieldwork.
In this role, you will:

• Travel frequently to engage with clients and team members, embracing opportunities to navigate diverse environments.
• Communicate with individuals effectively and compassionately, building trust and delivering exceptional care.
• Alternate between seated, standing, and active movement throughout your day, ensuring adaptability in every scenario.

Occasionally manage materials (up to 50 lbs.) to support your mission-driven responsibilities. Your dedication and adaptability will fuel transformative outcomes in this dynamic, impactful role.

Join us in creating a better way to care!