POPULATION HEALTH NURSE II

COMMUNITY HEALTH OF SOUTH FLORIDA INC•The Hammocks, FL

1d•$26 - $36

About The Position

The Population Health Nurse manages assigned patient populations based on chronic conditions, risk, or leadership direction, with the goal of achieving departmental performance goals and appropriate population health outcomes. The role provides ongoing VBS/HEDIS medical record collection and abstraction, supports abstraction for VBS/HEDIS compliance initiatives, and assesses provider performance against VBS/HEDIS standards and procedures. The position also helps patients and families access the health care system, coordinates care and referrals, tracks outcomes, and participates in patient and community education. It requires an active Florida RN license, current American Heart Association CPR certification, and a valid Florida driver’s license. The role is identified as non-exempt and requires attention to productivity standards, accurate documentation, confidentiality, and adherence to applicable policies and HEDIS/NCQA guidelines.

Requirements

Graduate from an accredited college or university with at least an Associate’s degree in Nursing or a nursing diploma.
At least two years of experience in a health care or related setting.
Experience in program development, project planning, and implementation.
Experience working with culturally diverse clients.
Knowledge of Joint Commission and other regulatory agency requirements.
Licensed to practice as a Registered Nurse in Florida.
Maintain current CPR certification from the American Heart Association.
Have a valid Florida driver’s license.
Excellent communication and interpersonal skills, including the ability to express ideas clearly and concisely in writing and orally.
Sensitivity when working with diverse cultural groups.
Proven problem-solving ability and a solution-oriented approach.
Ability to work independently and as a team member with coworkers, supervisors, and other staff.
Flexibility in work schedule and job assignments.
General working knowledge of utilization management, performance improvement standards and procedures, and NCQA standards.
Strong computer and data-entry skills, including efficient and effective computer use.
Ability to prioritize and multitask, achieve goals on time, work independently, and self-motivate.
Ability to read and interpret medical documents.
Ability to navigate and master practice management and EHR software programs.
Ability to meet measured productivity requirements in a high-production environment.
Maintain current licensure and/or certificates.

Nice To Haves

Bachelor’s degree in Nursing.
Experience in medical record review, data abstraction, and quality.

Responsibilities

Manage assigned patient populations based on chronic conditions, risk, or leadership direction to support departmental performance goals and population health outcomes.
Collect and abstract medical records for VBS/HEDIS and support related compliance initiatives.
Assess provider performance against VBS/HEDIS standards and procedures.
Coordinate home visits when warranted for non-compliant patients and participate in home visits when necessary.
Assist families in accessing the health care system and assigning patients to a medical home.
Collect and report outcome and referral results, including A1c, Pap smear, and preventive oral health visit results.
Collect required program data and maintain accurate records of activities performed.
Follow up on and track missed appointments and referral coordination to obtain outcome results.
Document patient contacts when following up on abnormal results.
Schedule appointments with health care providers, including primary care appointments for health risk assessments, preventive visits, and chronic care management.
Ensure accurate data entry for claim submission and maintain strong medical record review, data abstraction, and quality practices.
Work toward patient outcome goals established in the Section 330 Health Care Plan and participate in performance improvement activities.
Read and interpret medical documents; research medical history to identify the most appropriate source of necessary documentation.
Use knowledge of HEDIS criteria to identify medical information supporting specific HEDIS measures and ensure adherence to NCQA HEDIS guidelines.
Navigate and use practice management and EHR software programs.
Attend orientation, scheduled meetings, supervisor consultations, in-services, training courses, and appropriate continuing education.
Follow CHI policies and procedures, confidentiality policies, and HIPAA regulations; maintain current licensure and certifications.
Meet monthly productivity standards and measured productivity requirements; prioritize and complete work on time, independently and as part of a team.
Communicate effectively, follow appropriate communication channels, and promptly inform the supervisor of problems encountered in the line of duty.
Treat patients, clients, team members, and the public with courtesy, respect, and dignity, and present a positive public image.
Maintain flexibility in work schedule and assignments, including accessing families during non-traditional hours.
Report to work on time and ready to work, with minimal absenteeism.
Perform other duties as assigned.