SHS-POPULATION HEALTH QUALITY SPECIALIST-MED ASST

Sparrow•Lansing, MI

13d•Onsite

About The Position

As a member of the Population Health Service Organization (PHSO), the Population Health Quality Specialists (PHQS) will play an important role in redesigning the care provided for Sparrow Care Network (SCN). Serving both the employed, Sparrow Medical Group (SMG) primary care practices and the independent offices, the PHQS will be responsible for contract performance with a subset of the population. Tasks could include chart review/chart prep, review of quality metrics, outreach to patients needing an annual visit, and ongoing review of metric performance. This position will work on-site at the PHSO office, providing ongoing telephonic support for the practices. It will be essential that the PHQS possess a strong understanding of scheduling workflows, be comfortable communicating to all team members, and have a sense of adaptability working offsite and supporting multiple practices.

Requirements

Completion of a nationally or internationally accredited program in self-management support concepts and techniques within 12 months of assuming this position if not completed prior to being hired.
Minimum of 1 years of medical or case management experience
High school diploma or GED
Completion of a Medical Assistant (MA) program
Demonstrates excellent clinical knowledge, skills and judgment
Demonstrates excellent communication skills that include emotional intelligence, relationship building, negotiation, conflict resolution, persuasion, marketing, and patient advocacy.
Demonstrates ability to proactively and creatively problem solve.
Demonstrates the ability to prioritize, organize, handle many tasks simultaneously, work autonomously, and manage time.
Demonstrates the 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 utilize data for process improvement
Experience with an EMR
Proficiency in Microsoft Excel
Knowledge of case management that includes but is not limited to health care finance, hospital and community resources, discharge planning, utilization review, utilization management, ethical case management principles and evidence-based practice concepts

Responsibilities

Works with the internal Program Development team to understand prioritized tasks, participating in daily huddles
Provides prompt outreach to the assigned patients, while thoroughly documenting the conversation for team updates
Meticulously reviews the Electronic Medical Record (EMR) to assist in closing gaps in care
Understands the basic principles of risk capture, clearly identifying opportunities around Hierarchical Condition Categories (HCCs)
Coordinates care with the primary care practices for patients that need to be seen
Problem solves with patients to maximize their ability to follow preventative recommendations
Develops and maintains an effective professional working relationship with all patients, families, Physicians, Advanced Practice Providers (APPs) and additional care team members
Arranges education and referrals as needed for patients and families
Screens selected cases to identify needed services and interventions to deliver quality comprehensive care that addresses the patient’s full range of health care needs
Identifies issues, which may impact medical outcomes based on comprehensive assessments that may include the patient’s medical condition, support systems, finances, living situation, housing, behavior cognition, function/abilities, and the patient’s choice and/or preference
Collaborates with other members of the Sparrow Health System (SHS) team to collect, analyze, and utilize data for quality and process improvement activities
Works with office staff as part of an Interdisciplinary Team, develops and implements a plan which addresses problems and needs identified in the assessment and ensures continuity of care
Acts as the initial point of contact (POC) for the centralized team, as the group researches and implements new workflows to support the practices
Supports the development of new policies/procedures to ensure documentation is in place for the remote work
Pilots potential programming related to contract performance, closing quality gaps in care, capturing risk, and/or better supporting the practices utilizing a structured Plan, Do, Check, Act (PDCA) framework
Attends mandatory department and SHS meetings or trainings