Value-Based Care Outreach Specialist

Knowledge, Skills, and Abilities

• Must demonstrate knowledge regarding all Value-Based policies and procedures, governance structure and regulatory requirements through ongoing research and regular attendance at training webinars.
• Must have the ability to keep accurate records.
• Demonstrates excellent skills supporting program operations through successful completion of tasks and projects.
• Strong analytical skills to develop and analyze options and recommend solutions for complex problems and issues.
• High attention to detail and ability to interpret complex polices, rules and regulations.
• Ability to manage multiple priorities.
• Knowledge of value-based care scheduling requirements.
• Strong organizational, decision-making, and problem-solving skills.
• Excellent facilitation, conflict resolution and interpersonal skills.
• Demonstrated success in facilitating or supporting quality improvement efforts.
• Ability to generate professional, clearly written and spoken communication that is tailored to the audience.
• Must have the ability to handle stressful situations and to meet assigned deadlines.
• Excellent critical thinking skills.
• Must have strong EPM/EHR skills.
• Must have a valid driver’s license and willingness to travel.
• Must be able to effectively navigate patient engagement software in order to conduct patient recalls.

Qualifications/Education Requirements

      Qualified candidate should be a graduate of an accredited Medical. Assistant (MA) or nursing school and hold required certifications and/or licensure. Two years clinical experience in Value-Based care is preferred but not mandatory.  Must be proficient on Practice Management and Electronic Health Records/ Health Information Technology systems.

Core Competencies

• Completes tasks and projects needed to ensure all contracted Value-Based compliance with applicable rules and regulations defined by governmental agencies and commercial payers.
• Works closely with the Director of Quality Management to manage project scope, monitor timelines and deliverables, and communicate and identify pathways to resolve risks and barriers.
• Utilizes solid business planning principles to develop systems and processes that produce sustainable results and support ongoing operations of Value-Based care.
• Serves as the outreach contact-point, advocate, and informational resource for patients, family, care teams, payers, and community resources.
• Facilitates patient access to appropriate medical and specialty providers by scheduling Valued-Based Annual Wellness Visits (AWV) and other appropriate chronic care, medication compliance, and health maintenance needs.
• Schedules/tracks emergency department (ED) and transition of care management (TCM) follow-ups within a timely manner as specified by policy.
• Consistently presents a professional appearance in dress and grooming by adherence to dress code policy.
• Participates in and supports the organization’s Quality Assurance programs.
• Adheres to Health Insurance Portability and Accountability Act (HIPAA Privacy Rule) policies and procedures.
• Must be able to sit and/or stand for extended periods of time. 
• Functions independently and documents accurate and timely entries
• Adheres to policies/safety practices established by CFHC.
• Upholds, complies with, and enforces the Core Principles and Code of Conduct
• Perform other duties as assigned.