Coordinator Ambulatory Quality

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.

Primary Function/General Purpose of Position

The Population Health Coordinator is responsible for managing payer panels related to value-based contract quality and gap closure. This role serves as the primary lead for payer panel workflows, including monitoring and tracking patient-level detail through each stage of the workflow, and includes leading and operationalizing system-wide, bi-directional communication strategies with patients. This role is a vital component to the success of the value-based contract quality outcomes.

Essential Job Functions

• Acts as Bon Secours Mercy Health (BSMH) system-wide subject matter expert on value-based contract quality measures. This includes maintaining an expert level knowledge base of measures such as Breast Cancer Screening and Colorectal Cancer Screening.

• Actively operationalizes workflows for bidirectional communication with patients to support system-wide patient prevention and outreach strategies.

• Acts as a subject matter expert to support payer portals, including enhancing value-based contract performance with the identification of clinically relevant data.

• Optimizes workflows to support provider engagement through pre-visit planning, pre-visit charting, tracking outcomes data trends, and conducting patient outreach in coordination with practice guidelines.

• Supports and works closely with Program Managers and Clinical Integration leaders to support quality improvement efforts for Population Health Patients that are covered through any value-based contracts.

• Represents the Clinical Integration team and actively participates in payer operations meetings and responsible for providing updates to the BSMH Clinical Integration leaders and payers as it relates to assigned patient panel trends.

• Processes and maintains Protected Health Information (PHI) in compliance with BSMH policies and procedures, including electronically managing payer portals, patient lists and value-based patient level quality data.

• Utilizes value-based payer portals to identify data trends, upload clinically relevant data, and monitor progress toward overall value-based contract goal.

• Effectively communicates with patients to support gap closure workflows. This includes communication workflows including, but not limited to, phone calls and electronic medical record (EMR) platforms.

• Leads system-wide efforts to inform patient charts and payer portals with clinically relevant data to close value-based contract gaps.

• Maintains accurate patient lists to support value-based outcomes validation processes.

• Communicates clinical escalations when necessary. Conducts timely written, verbal, and electronic communication with providers, care teams, payers and BSMH leadership on patient specific opportunities.

• Leads outreach strategies and operations to support patients care gap closure. This includes directly communicating with patients via phone, email, and EMR.

• Performs patient research and documents findings in payer portals or other documentation system to support gap closure and demonstrated outcome delivery. This includes utilizing the Care Everywhere platform, the Epic EMR platform and various payer platforms.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Licensing/Certification

Certified Medical Assistant accredited by a recognized nationally organization or Licensed Practical Nurse (LPN) license in good standing. (required)

Education

High School Education or GED (required)

Associates Degree (preferred)

Work Experience

5 years of experience in a healthcare setting (required), preferably ambulatory practice with data management skills

Training

EPIC Electronic Health Record (preferred)

Patient Population

Not applicable to this position

Working Conditions

Periods of high stress and fluctuating workloads may occur.

Long-distance or air travel as needed- not to exceed 10% travel.

General office environment.

May be exposed to high noise levels and bright lights.

May be exposed to physical altercations and verbal abuse.

May be exposed to adverse weather conditions; cold, hot, dust, wind, etc.

May have periods of constant interruptions.

Required to car travel to off-site locations, occasionally in adverse weather conditions.

Prolonged periods of working alone.

Additional Physical Requirements/Hazards

Physical Requirements

Manual dexterity (eye/hand coordination)

Hear alarms/telephone/audio recordings

Reach above shoulder

Repetitive arm/hand movements

Finger Dexterity

Color Vision

Acuity - far

Acuity - near

Hazards

Not applicable to this position

Skills

Clinical Data

Data Evaluation

Data abstraction

Medical Charts

Electronic Medical records

Patient Outreach

Payer Integration Platforms

Microsoft Excel

Data Management

Following Instructions

Clinical Expertise

Prioritization

Active listening

Attention to detail

Relationship building

Critical thinking

Communication with all levels

Teamwork

Time management

Goal oriented

Self-motivating

Flexible

Problem-solving

Accountable

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans

Prescription drug coverage

Flexible spending accounts

Life insurance w/AD&D

Employer contributions to retirement savings plan when eligible

Paid time off

Educational Assistance

And much more

*Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health - Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email ~~~ . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at ~~~