Advanced Medical Assistant - MDPCP

About the role

The Advanced Medical Assistant is an essential part of the Advanced Primary Care Team and facilitates meeting the goals of the Maryland Primary Care Program and Value Based Contracts. Their main responsibilities are to coordinate patient care, provide patient outreach and education and identify barriers that may affect the patient from meeting his/her treatment goals.

Responsibilities

• Monitor and validate patient attribution to the practice and the care teams within the practice (known as empanelment).
• Ensure patients identified as increased risk receive targeted, proactive, relationship-based (longitudinal) care coordination and/or care management.
• Pre-visit planning workflow for Annual Wellness Visits scheduled with the LPN Team and/or practice provider.
• Provide patient education and resources to engage the patient in his/her treatment plan and improve their overall health.
• Actively manage assigned panel of patients to develop relationship with patient as an integral member of team, provide follow-up contact with patient as indicated to ensure compliance with recommendations medications, lab/x-ray, specialist visits, PCP visits, dieticians, CDE, etc.
• Maintain access to all Value Based Payor portals for attestation of metrics and/or to pull appropriate care gap and utilization reports.
• Provide patient outreach for TCM/ED visits within required timeframe, i.e. within 48 hours inpatient discharge; within 7 days emergency room discharge.
• Schedule a follow up appointment with the patients primary care provider or Advanced Internal Medicine.
• Aid patients in setting SMART goals for self-management, teaching them how to do self-management tasks and report abnormal findings to their provider team;
• Identify patient social and behavioral health needs, consult with clinician, as appropriate provide warm hand off to Ambulatory Care Management, social work, care navigation, and behavioral health services.
• Collaborate with providers, and other frequently used healthcare resources to develop effective timely communication between the patients care teams; and in assessing the patients progress toward individual health care goals.
• Oversee the development, procurement, and adoption of patient self-management educational resources used by the primary clinical teams.
• Ensure targeted patients who have received follow-up after ED, hospital discharge, or other triggering events receive short-term (episodic) care management if applicable.
• Contribute to a positive experience for patients and families through courteous telephone interactions and interview activities, accurate and expeditious routing, as well as referral to appropriate clinical staff when necessary.
• Recognize and report data inconsistencies to appropriate practice personnel, and facilitate appropriate data capture and reporting methodologies.
• Contribute to teamwork within and between departments. Regularly participate in meetings as deemed appropriate by leadership. Provide and receive constructive ideas, suggestions and feedback in a positive manner. Work collaboratively with co-workers to effectively resolve issues that impact departmental operations.
• Monitor and collaborate with practice to improve performance on key outcomes, including cost of care, electronic clinical quality measures, beneficiary experience, and utilization measures.

Requirements

• Minimum of High School Diploma
• Completion of accredited medical assistant training program preferred
• Three years of experience as a Medical Assistant
• Experience with Microsoft Office and Excel
• Strong customer service skills
• Basic math skills
• CMA, RMA or AAMA (through an approved/accredited organization)
• CPR Certified

Qualifications

• Must maintain Certification or credentials while employed required within 6 months of hire.

Skills

• Knowledge of care coordination/management
• Behavioral health resources
• CRISP Portal/Reports
• Value Based Contract Portals
• EPIC Registries
• Patient self-management tools/resources

Benefits

• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance
• Benefits Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more