Clinical Performance Lead

Monogram Health•Atlanta, GA

3h•Onsite

About The Position

We are seeking a highly motivated Clinical Performance Lead to support our clinicians and front-line staff in caring for our members affected by renal disease. As a Clinical Performance Lead, you’ll play a vital role at Monogram Health. We are looking for a proactive individual that can help us continually improve and enhance our clinical performance.

Requirements

Current, active unrestricted license as a Registered Nurse in assigned states/territories (compact licensing or multi-state licensing may be required).
Minimum 2-years of Registered Nurse experience within the last 5 years, or equivalent clinical experience.
Demonstrated knowledge and proficiency using technology.

Responsibilities

Review, update, and manage clinical interventions (CI), ad hoc tasking, and messages concerning visits. This may include the following (but not limited to): document CIs, coach and assist RNs on information needed for tasks (develop action plans with RNs concerning moving up visits, outreach to providers, and/or assist with obtaining updated lab work), make calls to members or physicians to complete tasks, review Care Manager documentation for CI, and review Holy Grail for records to complete tasks.
Assist APPs with requests, as well as help with SalesForce (coach/ educate on charting in SalesForce or assessments with RN visits, or tasks with CI).
Review appropriate sources (Athena or Health Gorilla) for records of our high-risk members/post-discharge members to better inform RNs at visits. Reviews may include missing or updated GFRs/A1c or pulling Nephrology/PCP/Specialty visit notes for CM review with patients at visits.
Perform concurrent review hospital calls (such as review hospitalized patients and discharges).
Conduct root cause analysis on certain members.
Attend leadership meetings, as needed, such as the MPE meeting.
Delegate action to the Patient Support Specialist team to request and receive office visit records for review.
Review and approve care plans.
Discuss patient care with field clinicians (regarding questions or concerns) and provide support and guidance. Also, address clinical escalations from field clinicians too.
Facilitate case rounds, PPA clinical rounds, and high-utilizer review, as well as document case rounds follow-up tasks.
Execute scheduling needs for high risk, high utilizer members.
Perform data analysis, such as data mining for records lab.
Address concerns and requests from Pod leadership, such as requests to address a charting concern or coaching for a RN/ NP on SalesForce, and requests to call a member or local providers for various reasons.
As needed, speak and document member conversations.
Delegate action to the PSS team to request and receive prescriptions and labs for review.
Delegate action to the PSS team to request and receive labs results for review.
Audit medical charts and review missing team visit notes (incomplete documentation). Also, review report and email documentation requests to CMs.
Conduct data analysis from various downloaded reports (such as ACP's due, CP's due, CRA assessment due, ACP's completed, BCBS enrolled, outstanding CP's due, and Visits 'in progress'.) and create data spreadsheets.
Daily review of documentation and provide guidance on IEs & PHDV.
Review and correct care plans to ensure compliance with SLA.
Provide Bullet Train care coordination.
Provide support to field team for escalations, clinical issues, patient outreach, and RR follow up calls.
Provide guidance and education on processes, workflows, and documentation to field staff, as well as review current and upcoming MH organizational changes.
Attend standard and ad-hoc operational meetings (on a daily, weekly, and/or monthly cadence). Examples of meetings include (but not limited to): weekly Team meetings, daily Pod Leadership meetings, daily CRS meetings, daily PHDV clinician update meetings, daily discharge planning/PHDV scheduling meetings, weekly Pharmacy rounds, weekly NP high-risk rounds, weekly Pod team huddles, weekly Pod Quad meetings, weekly Bullet Train meetings, weekly CC touch base meetings with Scheduling team, monthly Charl. Nephrology case rounds, monthly MH leadership training and meetings, CM/NP huddles and Pod Tear Sheet meetings, 1:1 meetings with staff, APP meeting, CI office hours meeting, CR meeting, HRR meeting, and Client partnership meeting.
Prepare slides and content for standard and ad-hoc operational and clinical meetings.
Assisting with scheduling needs, Teams chats, emails, and phone calls.
Build reports for specific members and their needs.