What are the responsibilities and job description for the Population Health Specialist position at Texas Health Care PLCC?
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 with 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 in-bound and out-bound 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 offices assigned
- 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 patients 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 relation 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, 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
