Population Health Specialist

About the role

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

Responsibilities

• Uses knowledge of HEDIS quality metrics to complete documentation gap closures for payer programs by using data collected in patient’s electronic medical records and or submitted from clinics.
• Identifies care gaps and distributes information to team members who will work with patients to coordinate care.
• Proactively requests patient records when the need is discovered and updates patient’s electronic medical records as applicable.
• Safeguards timely data submission of information to payers.
• Tracks and reports gap closures and participates in prayer meetings.
• Develops and maintains training materials for quality programs and assists with clinic trainings as directed.
• Manually conducts review of patients’ medical records seeking evidence/supporting documentation of care gap completion.
• Accurately updates medical records with new record information and or when data is found not to be in discrete data fields as trained.
• Through internal payer attestation processes, conducts manual care gap closures for records that have been completed and adequately documented.
• Provides support and or education to the utilization of network platforms or electronic health records where primary care practices can review quality and utilization performance and pull patient rosters and gaps of care.
• Facilitates practice improvement utilizing lean methodologies and best practices.
• Captures, tracks, reports, and communicates data and data analyses as required. Develops quality training materials that align with NCQA guidelines.
• Provides training to internal resources and clinics on payer quality measures and programs.
• Develops trusting, working relationships with primary care providers and support teams.
• Utilizes current healthcare research findings and other evidence to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues.
• Uses quality measures to improve performance and accountability for patient outcomes, patient experiences and safe delivery of care.
• Uses information technology to communicate, manage knowledge, mitigate error and support decision-making.
• Through chart reviews and observation, identifies opportunities to improve current processes and workflows that will enable providers and care teams to focus on care provision and to provide the highest quality care to patient populations.
• Assists in the development and execution of scalable, evidence-based strategies to improve quality performance across the network.

Requirements

• High School Diploma or GED required
• Bachelor Degree (in healthcare) preferred
• 2-3 years healthcare experience in an outpatient medical practice preferred.
• Proficient in use of computer applications, specifically Microsoft Office Products
• Experience with electronic medical records preferred.
• Experience with building training materials and training staff
• 1-2 years of experience with lean or six sigma methodologies
• Experience with payer quality programs preferred.

Qualifications

• High School Diploma or GED required
• Bachelor Degree (in healthcare) preferred
• 2-3 years healthcare experience in an outpatient medical practice preferred.
• Proficient in use of computer applications, specifically Microsoft Office Products
• Experience with electronic medical records preferred.
• Experience with building training materials and training staff
• 1-2 years of experience with lean or six sigma methodologies
• Experience with payer quality programs preferred.

Skills

• Knowledge of HEDIS quality metrics
• Ability to identify care gaps and distribute information
• Proactive record request and update capabilities
• Data submission and tracking proficiency
• Lean methodologies and best practices facilitation
• Training material creation and delivery
• Primary care provider and support team relationship development
• Current healthcare research and evidence utilization
• Quality measure usage for performance improvement
• Information technology communication and management
• Chart review and workflow optimization
• Evidence-based strategy development

Benefits

CommonSpirit Health offers a comprehensive benefits package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards.

Pay

The posted compensation range of $20.13 - $34.15 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting.

Schedule

Monday - Friday