Performance Improvement & Data Specialist, Physician Hospital Organization (PHO), 40-Hours, Monday through Friday, 8:15-4:45, monthly evening meetings, Hybrid

Heywood Hospital•Gardner, MA

2d•Hybrid

About The Position

This role involves collaborating with Physician Hospital Organization (PHO) physician offices to collect, evaluate, and report quality data for various measures such as HEDIS, CMS physician quality, and utilization measures. The specialist will develop and maintain databases and spreadsheets for tracking, prepare performance and trend reports, and assist with PHO provider membership approvals and MCO enrollment. The position also includes routine clerical support, attending meetings (including monthly evening meetings), updating OIG lists, managing meeting materials on Google Drive, and updating provider information for patient satisfaction surveys. The role requires strong communication and interpersonal skills, the ability to maintain confidentiality, and flexibility in prioritizing tasks. This is a hybrid position with a salary range of $79,000 - $102,200.

Requirements

Minimum high school graduate required.
Proficiency, knowledge and familiarity with databases (e.g., SQL) and a variety of Microsoft applications (e.g., Excel, Access) preferred.
Competent with additional Microsoft Office suite software (e.g., Word, PowerPoint, Outlook, etc.) and Google Workspace (e.g., Gmail, Drive, Docs, Slides).
Proficiency in computer software required (MS Office Products).
Advanced computer navigation and keyboarding skills, including ability to multi-task and navigate between multiple systems.
Ability to communicate effectively both verbally and written, administrative assistant skills, ability to perform typing, filing, record keeping and communicate with people of various educational levels.
Must be able to keep sensitive data confidential and adhere to all data security standards.
Demonstrated ability to work independently and as part of a team to enlist cooperation of many people to perform/achieve a common goal.
Ability to multi-task, organize and follow through on projects and assignments.
Must be well spoken, friendly, and outgoing.

Nice To Haves

Associates Degree preferred.
Preference given to those with an Associate Degree in administrative, business, health care/service fields, statistics, mathematics, or related field.
Certified coder or coder in training to obtain CPC and training in HCC concepts would be beneficial but not required.

Responsibilities

Collaborates with PHO Physician offices in the collection, evaluation and reporting of quality data for measures such as HEDIS, CMS physician quality and utilization measures, and other quality measures assigned to managed care plans.
May work with outside organizations and contracted services for quality data collection and reporting.
Develops and maintains databases and spreadsheets for tracking and contributes to system designs that help the PHO run efficiently.
Prepares individual practitioner and PHO aggregate performance and trend reports.
Works with the PHO Director to distribute important information and reports to PHO members and partners.
Collaborates with the credentialing office to assist in obtaining information required for PHO provider membership approvals and MCO enrollment.
Provides routine clerical support including taking minutes at meetings, typing letters, and maintaining PHO records and files for medical directors, physicians on Clinical Integration Committee and PHO Director.
Attends monthly evening meetings as well as events or receptions occasionally beyond regular business hours.
Updates OIG lists with PHO practices and runs LEIE Database comparison monthly.
Uploads meeting slides, summaries & educational attachments to Google Drive monthly for archive and reference.
Updates provider information for MHQP managed care patient satisfaction surveys used by MCOs annually.
Reports directly to the PHO Director, communicates daily with updates, supplies needed, changes in schedules etc.
Responds to e-mail and phone requests from provider offices and others on a timely basis.
Demonstrates excellent communication and working relationships with PHO physicians and their office staff as well as external organizations and agencies.
Delivers and picks up mail and appropriately processes sensitive mail via UPS, overnight mail, etc.as needed.
Coordinates delivery of checks for signature and mailing.
Works with Accounting personnel to maintain appropriate records, prepare check request submissions for PHO physicians and management, track physician management payments from managed care plans, etc.
Orders office supplies while maintaining budget constraints and ensures equipment is maintained, as needed.
Remains flexible, prioritizes assignments and tasks based on the needs of the PHO.
Provides general administrative support to the Heywood PHO Director and President of PHO.