Population Health Specialist

This position works under the supervision of the POPULATION HEALTH CONSULTANT. The POPULATION HEALTH SPECIALIST is expected to work closely with physician leaders, management, IT department staff, and the practice consultants to help Texas Health Care successfully meet the goals related to the Medicare Advantage and Medicare Shared Savings programs. The position will work with the physicians, office staff, and MA program nursing staff.

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 previous experience in a physician practice and/or a Medicare Advantage Program
• Excellent organizational skills
• Strong interpersonal skills
• Good verbal and written communication skills

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 base program patients to ensure metrics met for value base programs
• Handles confidential data in a professional manner.
• 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.