Population Health Advisor

Blue Cross and Blue Shield of Louisiana•Remote-LA, LA

9d•Onsite

About The Position

Responsible for assisting Medical Group and affiliate practices to implement best clinical practices with the goal of achieving the quadruple aim-better outcomes, lower costs, improved patient experience, and improved clinician experience. This position is responsible for working with practices to maximize the use of data to facilitate population health strategies to excel in value-based models. Partner with practices to facilitate process and workflow redesign efforts to achieve improved health outcomes. Success will be measured by expected reduction in total cost of care and expected improvements in quality and efficiency metrics.

Requirements

Bachelor's degree from an accredited university in Business, Nursing or a related field is required.
Four years of related experience can be used in lieu of a Bachelor’s degree.
5 years of experience in a dynamic, fast-paced healthcare environment is required.
2 years of demonstrated experience in analysis of financial and healthcare data which which includes all facets of data review, analysis, forecasting, graphics, presenting results and recommendations to management is required.
Experience working closely with physicians and their administrative staff in a clinical setting is required.
Experience implementing successful change management processes in organizations is required.
Thorough knowledge of the ambulatory health care and Patient Centered Medical Home, ACOs or similar population health and quality improvement models of care delivery.
Must be able to represent the company as a population health subject matter expert.
Excellent presentation, interpersonal and oral and written communication skills are required.
Requires strong interpersonal, negotiation, sales and relationship building skills along with the ability to persuade others and gain commitments to goals and objectives.
Must be able to successfully facilitate meetings, committees, seminars, and workshops to achieve established objectives.
Requires the ability to teach practices how to maximize technology. (EHR’s, registries, decision support tools, web, E-prescribing, and electronic health technology).
Microsoft Office Software proficiency is required: ability to perform intermediate level functions in Excel, Word, PowerPoint, Outlook, etc.
Requires excellent critical thinking, problem solving and problem resolution skills.
Must be able to manage multiple priorities and meet deadlines.
Requires the ability to work independently, on diverse teams and with internal and external staff at all levels (e.g. management, technical, administrative and support staff, physicians, etc.
Requires an understanding of the following: the health care industry (including NCQA standards), team- based approach to care delivery, Chronic Care Model, population health interventions and as well as contemporary performance improvement methods (PDCA, LEAN) and basic project management methodology.
Ability to travel approximately 20% of the time for in-state and out-of-state business is required.
The ability to comprehend, document, calculate, visualize, and analyze are required.

Nice To Haves

Education beyond bachelor's degree (e.g. Master of Business Administration, Nursing Degree, Health Administration, etc. is preferred.
In lieu of a Bachelor’s degree, more than 5 years of health care experience in business operations and/or a clinical setting, or a combination of both is preferred.
Experience with creating practice workflows to optimize care delivery, introduce best practices improvements, and evaluate outcomes is preferred.
Experience can run concurrently.
Experience with QI change management preferred.
Significant experience working with physicians, health care facilities or insurance plans to successfully implement change or train staff may be used in lieu of thorough knowledge of various plan models of care delivery.
Course work in Quality Improvement preferred.

Responsibilities

Works directly with the Director of Population Health Services and the Clinical data analyst and the provider practice to develop an Annual Plan for Performance Improvement that outlines the priority improvement targets as planned interventions.
Supports practice staff in the implementation of the Medical Group and affiliate practices’ population health and quality improvement programs and initiatives (recruitment, kick-off meeting, practice orientation, day-to-day support to the practice to help them achieve program goals, etc.).
Works directly with Medical Group and affiliate practices providers to represent and to assure the practices have what they need to successfully meet the goals of the Medical Group and affiliate practices program.
Assists practices in understanding their practice transformation needs to help them achieve their practice goals specific to population health and quality improvement models of care and assists the practices to meet goals and identified targeted standards, data collection needs, and achieve data integration to support Medical Group and affiliate practices’ population health and quality improvement programs and initiatives.
Creates policy and procedure templates and customized flows for care coordination integration for practices to use to work with the Medical Group and affiliate practices population health and quality improvement programs and initiatives.
Provides information and resources to practices, change management coaching and practice transformation to help them operate as high performing practices with population health and quality improvement models of care.
Assists and communicates directly with practices on key components of Medical Group and affiliate practices’ population health and quality improvement programs and initiatives, including, but not limited to their responsibilities and agreements as a Medical Group and affiliate practices program participant, role of the nurse care coordinator, use of data and medical decision support tools and reporting to manage care coordination as well as other expectations and key aspects of participation in the Medical Group and affiliate practices population health and quality improvement programs and initiatives.
Assures submissions of the practices’ data submissions and/or data integration requirements are clearly communicated to adequately support Medical Group and affiliate practices’ programs and initiatives’ quality and performance measurement process.
Provides coaching on improvement issues to participating teams.
Assists practice QI teams with understanding, interpreting and implementing their practice transformation plan to achieve program success criteria.
Oversees the Medical Group and affiliate practices agreements with Medical Group and affiliate practices’ population health and quality improvement program and initiatives to assure that both Medical Group and affiliate practices and provider practices are adhering to their contractual obligations.
Accountable for complying with all laws and regulations associated with duties and responsibilities.
Perform other job-related duties as assigned, within your scope of responsibilities.