Population Health Specialist

Sun River Health•City of Peekskill, NY

5d•$64,149 - $80,187

About The Position

The Population Health Specialist is responsible for supporting CHIPA’s partner organizations in achieving quality improvement outcomes across numerous payor programs through practice coaching and transformation support. The Population Health Specialist role is a hands-on position leading their assigned practices in improving Key Performance Indicators (KPIs) outlined in CHIPA’s Value Based Payment (VBP) agreements, as well as other quality improvement contracts. These KPIs include clinical quality measures, membership engagement, facility utilization, and costs and coding measures.

Requirements

Five years of healthcare or relevant experience
Highly organized with excellent oral and written communication skills
Able to manage multiple tasks and projects simultaneously
Excellent interpersonal, troubleshooting, and decision-making skills
Comfortable with continuous changes and self-initiation
Proficiency with Microsoft Office Suite (e.g., Excel, Word, Outlook) and Teams
Experience with electronic medical record systems
Familiar with HEDIS and QARR measures
Previous experience with quality improvement process
Basic knowledge of Project Management
Ability to maintain a non-judgmental disposition and communicate with a diverse population

Nice To Haves

Knowledge of value-based payment (VBP) arrangements
Understanding of medical billing and coding in a practice setting
Basic knowledge of payor claims processes

Responsibilities

Helps practices adopt, transform, and sustain CHIPA’s value-based model of care.
Acts as a principal contact for partner FQHCs.
Establishes a strong and positive culture of collaboration with assigned CHIPA partner FQHCs, including but not limited to:
Educating and training teams on quality measures specifications, including knowledge of appropriate billing codes and/or documentation needed by the payor to meet measure compliance.
Designing, implementing, and monitoring quality improvement processes, including continuous assessment of challenges in achieving stated goals.
Coordinates additional training initiatives needed by the FQHC, such as in the Population Health analytics tool and its application.
Assesses the capability of the FQHC to meet contract goals, considering its resources and experience around KPIs.
Maintains a reporting system to measure success and areas for improvement during the implementation and maintenance phases of transformation. Assists in creating performance dashboards and facilitating the request of custom reports to ensure the success of partners.
In collaboration with CHIPA partners, develop an outreach plan of action and follow-up for each quality measure to maximize contract terms.
Recommend resources that may be helpful to their assigned practice’s patient population, such as access to community resources, and self-management materials in multiple languages.
Building and coordinating innovative partnerships with multiple stakeholders (i.e. sharing best practices among partners), and when appropriate, assisting practices with patient engagement efforts.
Recommends workflow changes and adoption of new technologies (i.e. texting platforms and retinal imaging camaras) at partner sites. Identifying new/needed skills, processes, or methods to support a culture of performance improvement (i.e. project management and change management training).
Remains knowledgeable regarding the most up-to-date specifications for each contract measure.
When appropriate, research additional best practices to help with improvement initiatives. Coordinate meetings (in person or virtually) with staff for the purposes of training, and to discuss the performance of selected projects.
Attends and participates in meetings with stakeholders to include managed care plans, vendors, and workgroups.
Ensures practice success by conducting chart reviews and submitting supplemental data to health plans.
Coordinates practice training on the data analytics platform and makes recommendations for additional staff training. Coaches practices to independently access, analyze, and utilize analytic platforms to review their performance on KPIs.
Monitors performance of the clinical measures set forth by each contract at the FQHC-level, and at least on a quarterly basis, produces and analyzes KPI reports to identify measure trends, strengths and areas needing performance improvement plans. Provides feedback of such performance and analysis with their assigned practice.
Validates MCO and analytics platform data to ensure integrity of information and data hygiene using data mining techniques. Works with the appropriate liaison to achieve data accuracy.
When appropriate, reports practice-level performance information on KPIs with immediate CHIPA supervisor to support decision-making efforts.
With selected chair and co-chair, facilitates a monthly peer-to-peer workgroup comprised of health center staff, and at times, consultants. This includes, but is not limited to coordinating meeting schedules, completing meeting notes and meeting materials, distributing such materials and notes to the workgroup, and maintaining a central repository for documents and information from past meetings.
Develops workgroup projects, objectives, goals, and roadmaps
Encourages collaboration between workgroup members, as well as with other CHIPA existing workgroups
With input from workgroup leaders, summarize and report on workgroup progress to the Clinical Strategy Committee