SHS-POPULATION HEALTH QUALITY SPECIALIST-MEDICAL ASST

Sparrow•East Lansing, MI

8d•Onsite

About The Position

As a member of the Population Health Service Organization (PHSO), the Population Health Quality Specialist (PHQS) supports redesign of care provided for Sparrow Care Network (SCN). The role serves employed Sparrow Medical Group (SMG) primary care practices and independent offices, and is responsible for contract performance for an assigned subset of the population. Work may include chart review and preparation, reviewing quality metrics, contacting patients who need annual visits, and monitoring metric performance. The position is based on-site at the PHSO office and provides ongoing telephonic support to practices. The specialist needs a strong understanding of scheduling workflows, effective communication with all team members, and adaptability while supporting multiple practices remotely. The role works with patients, families, physicians, advanced practice providers, office staff, and other care team members to address care gaps, coordinate services, and support quality and process improvement.

Requirements

High school diploma or GED.
Completion of a Medical Assistant (MA) program.
At least 1 year of medical or case management experience.
Complete a nationally or internationally accredited program in self-management support concepts and techniques within 12 months of assuming the position if not completed before hire.
Demonstrated excellent clinical knowledge, skills, and judgment.
Excellent communication skills, including emotional intelligence, relationship building, negotiation, conflict resolution, persuasion, marketing, and patient advocacy.
Ability to proactively and creatively solve problems.
Ability to prioritize, organize, manage multiple tasks simultaneously, work autonomously, and manage time.
Ability to work in stressful situations and manage conflict.
Ability to work in an EMR environment.

Nice To Haves

Certified Medical Assistant.
Knowledge and demonstrated ability to collect, analyze, and use data for process improvement.
Experience with an EMR.
Proficiency in Microsoft Excel.
Knowledge of case management, including health care finance, hospital and community resources, discharge planning, utilization review, utilization management, ethical case management principles, and evidence-based practice concepts.

Responsibilities

Work with the internal Program Development team to understand prioritized tasks and participate in daily huddles.
Conduct prompt outreach to assigned patients and thoroughly document conversations for team updates.
Review the Electronic Medical Record (EMR) to help close gaps in care.
Apply basic risk-capture principles and identify opportunities related to Hierarchical Condition Categories (HCCs).
Coordinate with primary care practices for patients who need to be seen.
Help patients overcome barriers to following preventive care recommendations.
Develop and maintain effective professional working relationships with patients, families, physicians, advanced practice providers, and other care team members.
Arrange education and referrals for patients and families as needed.
Screen selected cases to identify services and interventions needed for quality, comprehensive care addressing patients’ health care needs.
Identify issues that may affect medical outcomes based on comprehensive assessments, including medical condition, support systems, finances, living situation, housing, behavior, cognition, function or abilities, and patient choices or preferences.
Collaborate with Sparrow Health System team members to collect, analyze, and use data for quality and process improvement.
Work with office staff as part of an interdisciplinary team to develop and implement plans addressing identified problems and needs, and ensure continuity of care.
Serve as the initial point of contact for the centralized team as it researches and implements workflows to support practices.
Support development of policies and procedures to ensure documentation is in place for remote work.
Pilot programming related to contract performance, closing quality gaps, capturing risk, or better supporting practices using a structured Plan, Do, Check, Act (PDCA) framework.
Attend mandatory department and Sparrow Health System meetings or trainings.
Perform additional duties as assigned by the leader.