Population Health Transformational Specialist

About the role

We are currently seeking high-energy, engaging leaders with a passion for population health to help transform healthcare in the southeast. As a Population Health Transformation Specialist, you will lead the transition to outcomes-based care across multiple clinics, serving as the primary partner for providers, managers, and staff at each location on all matters related to population health.

Responsibilities

• Lead the transition to outcomes-based care across multiple clinics.
• Support providers in understanding and utilizing available population health tools and technology.
• Assist in the development and implementation of pathways that support providers and practices in transitioning to value-based care.
• Drive department initiatives, track individual performance goals, and provide ongoing training and education on quality measures, accurate RAF reporting, and strategies for closing care gaps.
• Collaborate with partners to achieve population health priorities while staying up-to-date with regulatory standards and guidelines, including HEDIS and STARs.

Requirements

• Strong communication and relationship building skills.
• Serve as a liaison to practice directors and managers along with clinical staff to facilitate implementation of population health initiatives.
• Provide direct support for provider achievement in improved financial, process and clinical outcomes.
• Problem solve with the intent to achieve effective progression of implementing initiatives.
• Work with the team to identify and develop recommendations for improvements as needed.
• Absorb and interpret summary data and performance reports for practices and clinicians.
• Meet project specific goals and timelines.
• Share best practices within the organization.

Qualifications

• Demonstrated experience with: Value-Based Payor Programs (incl. understanding of HEDIS Coding); HEDIS, STARS ratings and other population health initiatives.
• Electronic Health Record (eHR) use and documentation. Allscripts/Veradigm experience preferred.
• Demonstrated experience training clinical staff on value-based programs and requirements.
• Demonstrated experience with auditing documents for gap-closure requirements.
• High-school graduate (Associates preferred).

At 90 Days

• The Population Health Transformation Specialist is expected to demonstrate a growing competency in the following areas aligned with the minimum requirements of the role:
• Understanding of Value-Based Payer Programs
• Working knowledge of SEMG Value-Based Care (VBC) programs.
• Understand core principles of HEDIS gap closure with CPT II coding and its role in quality performance.
• Be able to explain basic VBC concepts to clinical team members in a clear, practical manner.
• Identify and track core HEDIS and STARS measures for assigned practice locations.
• Understand how these measures are used to drive care improvement and payer incentives.
• Demonstrate ability to assist in tracking performance metrics at the practice or provider level.
• EHR Use and Documentation (Veradigm & eCW)
• Achieve proficiency in navigating and retrieving supporting documents for gap closure within the organization’s EHR system.
• Be able to communicate documentation best practices for closing care gaps and reporting on quality measures to clinical staff.
• Training and Communication Skills
• Begin co-facilitating training sessions with managers and clinical team.
• Build confidence in presenting VBC workflows and expectations to clinical staff.
• Effectively communicate feedback or guidance to providers related to VBC performance.
• Audit and Compliance Support
• Learn and apply standard audit processes for documentation and care gap closure.
• Accurately review charts and flag discrepancies or missed opportunities.
• Collaborate with peers or leads to report findings and support corrective action plans.

Physical and Mental Requirements

• Ability to lift up to 50 pounds.
• Ability to push or pull heavy objects using up to 50 pounds of force.
• Ability to sit for extended periods of time.
• Ability to stand for extended periods of time.
• Ability to use fine motor skills to operate office equipment and/or machinery.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to use logical reasoning for simple and complex problem solving.
• Ability to travel to multiple locations to support business needs as required.

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