Specialist, Clinical Care Gap & Data Quality

Description

• Assist in the development, monitoring of Azara and ensure all metrics are accurate and up to date
• Routinely and proactively reviews patient medical records, claims data and other relevant information to identify care gaps.
• Assess urgency and potential impact of care gap closures across all Value Base Programs.
• Training and presentation of Azara features in Population Management courses
• Develop dashboards and reports within Azara to monitor clinical performance and identify areas for improvement
• Conduct comprehensive reviews of patient records and regular data audits to identify clinical care gaps, inconsistencies, and potential quality issues
• Collaborate with clinical teams to develop strategies for closing care gaps and improving UDS reporting measures
• Collaborate with EHR Trainers to improve clinical training on where to document to meet measures
• Coordinate tracking and reporting of clinical outcomes, and follow-up of corrective action plans
• Responsible for developing methods for data collection and extracts data as required  
• Assist with coordination of monthly QI meetings in alignment with program requirements
• Prepare QI reports and statistics
• Assist with the management of all clinical quality measures as they pertain to all health center program requirements
• Assist with UDS and HRSA reporting requirements and actively engages in improvement activities involving them
• Have working knowledge of HEDIS measures and UDS reporting  
• Participate in payor meetings as they relate to value-based care and care gap closure
• Assist with Vatica Health by outreaching to patients for visits, reconciling the insurance rosters, and assisting the providers with Well365 navigation to ensure we reach the maximum potential
• Communicates with patients and utilizes connection with outside facilities to obtain information on appropriate documentation needed to close care gaps
• Outreach to patients for priority visits and encourage them to complete specific health screenings as they relate to the Value Based Program. 
• Generate necessary orders for patients needing testing
• Provide clear and concise explanations about the importance of care gap closures across the enterprise
• Clearly and consistently document all patient interactions as they relate to care gap closures in the patient’s medical record.
• Provide patient specific education based on their specific insurance plan to better help them manage their condition.
• Implement system wide fixes to ensure the organization is able to achieve its optimal score across all Value Based Programs
• Knowledge of SDOH and all community resources we have to offer to patients

Requirements

•   Meet The Wright Center for Community Health and its affiliated entity The Wright Center for Graduate Medical Education EOS© People Analyzer Tool
• Buy in and experience working in the EOS® model (strongly preferred)
• Mission-oriented; represents the enterprise in a professional manner while demonstrating organizational pride
• Bachelor’s degree in a healthcare-related program or other related field preferred or minimum 5 years healthcare experience 
• Knowledge of EHR (Electronic Health Records) systems preferably Medent 
• Knowledge of Microsoft Office software 
• Must be focused, self-directed, organized, and have demonstrated problem-solving abilities 
• Accurate and precise attention to detail 
• Excellent verbal and written communication skills 
• Able to work both independently and as part of a team 
• Must possess team leadership skills and have a positive disposition 
• Valid drivers license