Population Health Transformational Specialist

Southeast Medical Group•Woodstock, NY

1d•Hybrid

About The Position

We are currently seeking high-energy, engaging leaders with a passion for population health to help transform healthcare in the southeast. As a Population Health Transformation Specialist, you will lead the transition to outcomes-based care across multiple clinics, serving as the primary partner for providers, managers, and staff at each location on all matters related to population health. This role involves frequent site visits to assigned practices to support providers in understanding and utilizing available population health tools and technology. Specifically, you will assist in the development and implementation of pathways that support providers and practices in transitioning to value-based care. You will drive department initiatives, track individual performance goals, and provide ongoing training and education on quality measures, accurate RAF reporting, and strategies for closing care gaps. As an integral member of each partner practice, you will collaborate with them to achieve population health priorities while staying up-to-date with regulatory standards and guidelines, including HEDIS and STARs.

Requirements

Strong communication and relationship building skills.
Demonstrated experience with Value-Based Payor Programs (incl. understanding of HEDIS Coding).
Demonstrated experience with HEDIS, STARS ratings and other population health initiatives.
Electronic Health Record (eHR) use and documentation.
Demonstrated experience training clinical staff on value-based programs and requirements.
Demonstrated experience with auditing documents for gap-closure requirements.
High-school graduate (Associates preferred).
Understanding of Value-Based Payer Programs.
Working knowledge of SEMG Value-Based Care (VBC) programs.
Understand core principles of HEDIS gap closure with CPT II coding and its role in quality performance.
Be able to explain basic VBC concepts to clinical team members in a clear, practical manner.
Familiarity with HEDIS, STARS, and Population Health Initiatives.
Identify and track core HEDIS and STARS measures for assigned practice locations.
Understand how these measures are used to drive care improvement and payer incentives.
Demonstrate ability to assist in tracking performance metrics at the practice or provider level.
Achieve proficiency in navigating and retrieving supporting documents for gap closure within the organization’s EHR system.
Be able to communicate documentation best practices for closing care gaps and reporting on quality measures to clinical staff.
Begin co-facilitating training sessions with managers and clinical team.
Build confidence in presenting VBC workflows and expectations to clinical staff.
Effectively communicate feedback or guidance to providers related to VBC performance.
Learn and apply standard audit processes for documentation and care gap closure.
Accurately review charts and flag discrepancies or missed opportunities.
Collaborate with peers or leads to report findings and support corrective action plans.

Nice To Haves

Allscripts/Veradigm experience preferred.
Veradigm & eCW EHR experience.

Responsibilities

Lead the transition to outcomes-based care across multiple clinics.
Serve as the primary partner for providers, managers, and staff at each location on all matters related to population health.
Conduct frequent site visits to assigned practices to support providers in understanding and utilizing available population health tools and technology.
Assist in the development and implementation of pathways that support providers and practices in transitioning to value-based care.
Drive department initiatives and track individual performance goals.
Provide ongoing training and education on quality measures, accurate RAF reporting, and strategies for closing care gaps.
Collaborate with partner practices to achieve population health priorities.
Stay up-to-date with regulatory standards and guidelines, including HEDIS and STARs.
Serve as a liaison to practice directors and managers along with clinical staff to facilitate implementation of population health initiatives.
Provide direct support for provider achievement in improved financial, process and clinical outcomes.
Problem solve with the intent to achieve effective progression of implementing initiatives.
Work with the team to identify and develop recommendations for improvements as needed.
Assist with the development of proposals, updates and summaries of provider performance.
Assist in the development and execution of work plans to drive improvement in capturing quality measures and properly set patient risk scores.
Communicate areas of concern, needed resources, or barriers to achieving goals.
Assist with monitoring and developing pathways for success for any providers experiencing underperformance and communicate strategies developed by the pop-health department for improvement.
Review and interpret summary data and performance reports for practices and clinicians.
Meet project specific goals and timelines.
Share best practices within the organization.