Basic Function:

To identify areas for improvement regarding patient care quality by conducting audits, and identifying trends, supporting data capture for Value Based Contracts and HEDIS Measures. 

Principal Accountabilities:

1. Review Gaps in Care for Quality Incentive initiatives through payor contracts, Independent Provider Association (IPA) contracts, Accountable Care Organization (ACO) contracts, and Social Care Networks Contracts 
2. Patient outreach as required by contracts or as requested by Supervisor
3. Complete Value Based Payments (VBP) and other alternative payment metric evaluations and follow-up as requested by management as well as insurance companies (payors) by performing chart audits
4. Generate reports on population health metrics and outcomes 
5. Assist other departments with pending/open referrals and open order reports as requested by Supervisor
6. Assist with and promote all processes associated with the Coleman initiative
7. Promoting Patient Centered Medical Home (PCMH) initiatives
8. Other duties and responsibilities as requested by supervisor and/or management

Knowledge/ Education Requirements:

A. High school graduate or GED, associate degree preferred

B. Prior population health or ambulatory care experience preferred

C. Verbal and written communication skills, medical office applications preferred

D. Demonstrate proper judgment and decision-making skills  

E. Must demonstrate computer proficiency with electronic medical record system