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PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Position Overview Responsible for assisting Population Health Strategist and Manager in achieving successful execution, coordination and support of PacificSource's clinical/quality improvement initiatives, across all lines of business. Key areas of focus include customer support to provider clinical engagement and performance on patient populations. This is done through supporting Population Health team manage targeted provider groups to guide and develop practice specific strategies designed to optimize clinical quality outcomes, risk assessment performance, and clinical outcomes via care management and cost containment. Support internal PacificSource departments to build/strengthen relationships with strategic provider partners; generate specific clinical reports and proactively identify clinical improvement opportunities that support PacificSource's strategic goals. Assist with execution of region specific strategies and practice coaching.
Essential Responsibilities:
Assist with the development and execution of enterprise wide provider campaigns focused on improving clinically oriented improvement and outcomes.
Provide customer service and support to network providers and clinic staff toward the development and implementation of improvement initiatives (clinical quality, member experience, clinical workflows, and documentation/coding practices) within their own practices.
Assist Population Health Strategist to establish credible, consultative relationships with network providers and clinic staff by acting as first point of contact for questions and basic quality improvement and risk assessment needs.
Maintain a detailed understanding of all shared data elements (clinical outcomes, ICD-10 coding, and documentation) and the systems necessary to support actionable interventions.
Support internal initiatives to improve the collection and reporting of supplemental data as related to provider populations and regional reach by behavioral health priority populations.
Prepare and supply clinical data and gap reports to provider partners in alignment with outline goals and objects set in place with Population Health Team. Offer guidance and training on use of reports to provider partners.
Evaluate quality programs, initiatives and interventions utilizing multiple data sources to determine the effectiveness of activities and make recommendations to improve outcomes for QIMs.
Support all clinical and quality dyads with provider payer partnerships to optimize engagement, drive performance and improve provider/member experience in service to growth strategy.
Co-develop ongoing training, coaching, and support for network providers/operations staff to develop and implement improvement initiatives: gap closures, member experience, documentation, and outcomes as captured by value based payments.
Maintain credible, consultative relationships with internal and external stakeholders to coordinate and decrease member abrasion and mitigate risks to population health initiatives.
Elevate and share feedback from external stakeholders to internal departments; establish mechanisms which proactively facilitate reciprocal resolutions
Ensure collaboration with Utilization Management, Care Management, Provider Network to develop and deploy aligned quality performance programs to drive better provider satisfaction and quality outcomes.
Co-create and maintain detailed understand of shared data elements and the systems necessary to support actionable interventions which support internal initiatives aimed to improve continuous process improvement regarding collection of relevant data.
Partner with Behavioral Health Clinical Quality Improvement to determine effectiveness of ongoing technical assistance rendered to providers to support Oregon Administrative Rule and Fidelity Review governed programs.
Facilitate meaningful engagement of multidisciplinary teams to support engagement activities and performance targets cited within the regional Comprehensive Behavioral Health Plans.
Supporting Responsibilities:
Contribute to Quality Improvement internal committees and workgroups.
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
Perform other duties as assigned.
SUCCESS PROFILE
Work Experience:
Minimum of 3 years of experience in the healthcare industry. Health care clinic experience required. Operational leadership or clinic operations preferred and/or other Population Health Program implementation experience.
Education, Certificates, Licenses:
Bachelor's Degree in healthcare administration or clinical certification required. Master's degree or clinical license preferred.
Knowledge:
Knowledge/experience with quality improvement initiatives in the clinic setting including clinical quality outcomes and patient experience. Knowledge of state quality measures such as QIMs required. Strong computer skills using Word, Excel, and PowerPoint. Experience with medical billing, claims processing systems, data analytics, and health care information strongly preferred. Knowledge and experience implementing continuous improvement efforts or LEAN concepts strongly preferred. Must have strong analytical, influencing, and problem solving skills. Understanding of quality initiatives, evidence based medicine and care coordination required. Demonstrated ability to effectively communicate with all levels of a staff and management including executive leaders. Proven ability to learn new healthcare information systems and work with multiple business systems. Must be self-motivated, organized, and detailed oriented.
Competencies:
Building Trust
Building Customer Loyalty
Facilitating Change
Driving for Results
Building Strategic Work Relationships
Leveraging Diversity
Decision Making
Building a Successful Team
Aligning Performance for Success
Continuous Improvement
Environment:
Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 25-50% of the time.
Skills:
Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
