Performance Improvement Coordinator - Flagstaff - SHCN
Position Purpose: The Performance Improvement Coordinator works in collaboration with physician practices to execute on opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance.
Works in collaboration with physician practices to target opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance. Maintains collaborative team relationships with peers, colleagues, and physician practices in order to effectively and efficiently achieve goals and foster a positive work environment. Supports process improvement to enhance physician and staff workflow and drive performance improvement. Supports medical record data review/collection as it relates to performance improvement goals for risk adjustment and quality management purposes, including contractual obligations. Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment and Quality performance measures, like HEDIS.
Interacts with providers regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation. Coordinates and communicates with local Health Plan management to track and share data with practices on performance against goals, escalating issues at the practice level in a timely manner. Works collaboratively with assigned practices staff, including Performance/Quality staff and Office Managers to coordinate improvement efforts. Implements performance improvement plans at the practice level and support monitoring and evaluation of performance by following policies and procedures for tracker data entry and maintenance.
Produces and maintains record by keeping documentation updated real-time and reporting progress on a weekly basis. Provides dashboard reports to providers and practices with recommendations on improvement, establishing and implementing accountability for performance improvement.
Educates providers and leadership on clinical indicators to capture the severity of illness of the patient. Assists in preparation of training materials (Provider and Practice-facing). Provides leadership and staff with training, on-site collaboration and on-going performance reporting.
· Medical Assistant or LPN license preferred, or equivalent clinical experience.
· 2-3 years of physician practice experience preferred.
· Basic understanding and ability to use Excel spreadsheets preferred.
· Knowledge of quality metrics and risk adjustment preferred.