Job Type: Regular
Time Type: Full time
Work Shift: Day (United States of America)
FLSA Status: Exempt
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Under the supervision of the Quality Manager, the Senior Population Health Specialist (PHS) supports collaboration, communication and care coordination with all members of the health care team, including but not limited to practices, clinicians, leadership and support staff. The Senior Population Health Specialist leads cross-functional activities throughout the organization to support population health programs and ensure effective implementation of these activities to gain positive outcomes. They will partner with the Manager of Quality to ensure safety, best practice and high-quality standards of care across the health care continuum to achieve the quality incentives as part of global payment and managed care contracts with the goal of optimizing our patients' health and well-being, ensuring that contractual metrics are met, and maximizing financial revenue in our quality risk arrangements. This role facilitates strategic process improvement initiatives through planning, development, and operationalization of performance improvement projects. Ensures the improvement initiatives meet organization goals and requirements. Assists the health care team in implementing and using systems and interventions to improve patient care and outcomes by identifying key drivers of performance and implementation of project plan(s) to impact those key drivers. The ideal candidate must have knowledge of how population health is integrated throughout the organization and will support program design and implementation.
Job Description:
1. Serves as subject matter expert on HEDIS ambulatory quality measures and uses that knowledge to effectively communicate information as the central resource to assigned hospital, POD leaders, physician groups and clinical teams participating in the BILPN risk arrangement quality programs.
2. Acts as a key resource to practice(s) for the management of registries of patients that have chronic diseases to ensure they have the required testing and medication management to promote optimal health and clinical outcomes.
3. Works collaboratively with practice/providers to develop campaigns to address gaps in care, monitors patient and practice/provider compliance with campaigns and provides feedback and adjustment as needed to ensure success.
4. Supports process improvements to enhance clinician and staff workflows by identifying potential barriers and making recommendations on improvement initiatives. Audits performance based on recommendations and evaluates compliance and engagement. Effectively communicates key findings to drive informed decision making.
5. Provides expertise, training, and ongoing support for quality measures and the EHRs and related clinical and technical systems which support the collection and tracking of such measures.
6. Monitors performance trends for key performance measures, identifies data and reporting needs, and disseminates or makes available performance trends on a regular basis to care teams. Ensures practices and clinicians are informed on current performance and areas of opportunity for improvement.
7. Provides an effective communication link between practices and clinicians and BILHPN leadership. Escalates issues and/or concerns with practice engagement, participation or performance to quality manager and medical director as needed.
8. Identifies and communicates best practice opportunities to practices, clinicians and team members to help improve performance. Participates in team decisions regarding data requirements for pro-actively managing the team’s panel.
9. Supports large scale special projects to drive network quality performance. Special projects may include workflow development/optimization, specialist engagement, and training/education design and implementation.
10. Coordinates with Manager of Quality for Population Health Specialist team oversight, including on-boarding, team huddle leadership, population health analytics training and support, and practice coverage as necessary.
11. Performs other duties as assigned.
Organizational Requirements:
Maintain strict adherence to all BILH and BILHPN Policies. Maintain courteous and effective interactions with colleagues and providers and stakeholders. Demonstrate an understanding of the job description, performance expectations, and competency assessment. Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to customer service standards. Participate in departmental and/or interdepartmental quality improvement activities. Participate in and successfully complete Mandatory Education. Perform all other duties as needed or directed to meet the needs of the department.
Minimum Qualifications:
Education: Bachelor’s degree
Licensure, Certification & Registration: Medical Assistant Certification
Experience: Minimum 3-5 years related experience in a health care environment.
Skills, Knowledge & Abilities: Strong knowledge of and experience with HEDIS ambulatory quality measures a must. Ability to travel to offsite meetings at various provider practices and hospitals. Strong knowledge in Microsoft Office applications – Word, Excel, Access, PowerPoint, Teams, and other web-based applications. May produce complex documents, perform analysis and maintain databases. Knowledge of process improvement initiatives such as LEAN or Six Sigma a plus. Ability to thrive in fast-paced environment. Strong troubleshooting and organizational skills. Excellent verbal and communication skills. Ability to excel in relationship building. Must be agile in mindset and skills. Must be able to pay close attention to detail and work as a member of the care team to ensure excellent customer service. Knowledge of electronic medical records; eClinical Works, Athena, WebOMR, Arcadia or Epic a plus.
As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.
More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
Equal Opportunity Employer/Veterans/Disabled
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