Value Based Care Coordinator

About the role

The Value Based Care Coordinator (VBCC) bridges the gap between patients, Piedmont Health Services, and insurance networks to close open care gaps, support transitional care and improve overall health outcomes. This role is dedicated to monitor performance metrics, supplies insurers the supporting documentation requested, ensure chronic conditions are assessed and documented annually as well as conduct patient outreach to close open care gaps. The VBCC will meet regularly with insurance network representatives to discuss measure performance, incentive opportunities and recommended actions. The VBCC will monitor and track payor attribution assignments and assist with quality improvement projects, as well as provide performance data to Population Health Leadership, Quality and Clinical teams at departmental or site meetings. Additionally, the VBCC will conduct chart reviews to verify care gap reports and attempt to close the verified care gaps by conducting patient outreach and scheduling.

Responsibilities

• Obtains and uploads documents into the population health platforms database.
• Assists with care gap assessments and closures.
• Conducts chart reviews to verify care gap data reports.
• Submits supplemental data to health plans to provide documentation of gap closure.
• Meets and collaborates with payor representatives
• Collaborates with the care team and Population Health Manager in quality improvement projects.
• Ensures urgent issues are shared with care team.
• Conducts care gap outreach and scheduling.
• Participates in all assigned meetings.
• Adheres to privacy and security policies to ensure patient and company data is properly safeguarded.
• Follows company policies and HIPAA regulations.
• Meets productivity and role expectations, and addresses requests in a timely manner.
• Other duties, as assigned.

Requirements

• High school diploma or equivalent, required.
• Bachelor’s degree in social work, healthcare administration, human services, public health or related field, preferred.
• 2 years of experience in a healthcare organization, required.
• 1 – 2 years of case management, social work, or relevant work experience, preferred.
• Bilingual, preferred.
• Maintains a valid driver’s license with auto liability insurance.

Qualifications

• Knowledge of and experience working in patient data systems.
• Proficient with MS Office.
• Knowledge of state and federal benefits systems.
• Excellent communication skills – oral and written.
• Excellent organizational and time management skills.
• Sensitivity to diversity of cultures, language barriers, health literacy and educational levels.
• Knowledge of medical terminology.
• Able to respond to changes with a positive attitude and willing to learn new ways to accomplish activities and objectives.
• Able to shift our approach in response to the demands of a situation.
• Detail oriented.
• Immunizations: Be medically cleared for communicable diseases and have all immunizations up-to-date prior to beginning employment

Benefits

• Medical, Dental, Vision, Life Insurance (Short & Long Term Disability)
• 403(b) Plan
• Paid Holidays
• CME (Continuing Medical Education)

Pay

$22.49/Hourly - $30.23/Hourly (commensurate with years of experience)

Schedule

Monday through Friday, 8:00am to 5:00pm