- Maintains utmost level of confidentiality at all times.
- Adheres to Health System and Health Plan policies and procedures.
- Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
- Demonstrates a high degree of independence, flexibility, initiative and commitment while at the time demonstrates the capacity to work in teams developing and maintaining excellent working relationships with positive interactions that positively improve productivity across all organizational areas of function. Serves as a "change agent" to continually develop and improve Health Home operations and outcomes.
- Performs assessment of provider practices to determine compliance with Driscoll Health Home Category selection and facilitates operationalization for all qualified providers requesting inclusion.
- Coordinates management of key metrics and performance improvement projects associated with state mandated projects and other quality improvement initiatives and/or alternative payment models relative to Driscoll Health Homes, as indicated.
- Demonstrates the ability to work with both internal and external data sources, transforming data into information through standard analytic methods.
- Provides insights, both written and verbal as well as recommendations, after data analysis specifically as this applies to all potential Driscoll Health Home data sources (e.g. Quality Management, Health and Human Services [HHSC] Performance Improvement Projects [PIP], HHSC initiatives including but not limited to Pay for Quality [P4Q], Quality Assessment and Performance Improvement [QAPI], etc.) related to the DHP Health Home Project.
- Provides leadership in the development of other health plan initiatives or programs related to data collection, retrieval, analysis and interpretation to assist in optimizing outcomes and/or effectiveness and efficiency as time permits.
- Develops and identifies appropriate applications utilized for tracking and monitoring of Driscoll Health Homes.
- Performs internal audits and/or case assessments to identify opportunities for improvement.
- Facilitates a process to evaluate the effectiveness of the Driscoll Health Home program.
- Assists other departments, as needed, to develop operational oversight functions as it relates to the Driscoll Health Home initiative.
- Provides training materials related to the Driscoll Health Home initiative for internal and external customers/stakeholders, as needed.
- Serves as an expert on Driscoll Health Home data production and interpretation
- Communicates in person and by other means with network physicians who are participating in or have indicated an interest in the Driscoll Health Home initiative.
- Demonstrates the ability to work in teams developing and maintaining excellent working relationships with positive interactions that positively improve productivity across all organizational lines
- Demonstrates well-developed and proven organizational, problem solving, analytical skills, customer service, and oral and written communication skills.
- Maintains a global perspective and anticipates the impact of analytic results that may have an effect on other program stakeholders.
- Demonstrates leadership, organization, collaboration, and critical thinking in addressing decisions and resolving issues.
- Performs other duties as requested.
- Bachelor's degree in Nursing, Population Health or other related equivalent field required. Master's degree preferred. (MPH, MBA, MSN, MHA, etc.)
- At least two years of relevant project management and/or performance improvement experience preferred.
- Previous experience in managed care preferred.
- At least three years of health care experience required.
- Experience with computer programs, including Microsoft Office programs (Word, Excel, and PowerPoint) required.
- Current unrestricted Registered Nurse Licensure in the state of Texas-if applicable
- CPHQ certification preferred
- Clinical Informatics certification desirable
- Project Management certification desirable
- Prior experience working with clinical information systems preferred.
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Health Home Coordinator - Corpus Christi, United States - Driscoll Children's Hospital
Description
Where compassion meets innovation and technology and our employees are family.
General Purpose of Job:
The Driscoll Health Home Coordinator collaborates with all Driscoll Health Plan (DHP) departments to assess, plan, develop, facilitate, implement, and monitor all operational activities with regard to the Driscoll Health Home Model. The Driscoll Health Home Coordinator is responsible for tracking the progress and impact of Driscoll Health Home initiatives with regard to internal and external quality performance. This position is responsible for forecasting, monitoring, analyzing, compiling, drafting recommendations and developing proactive strategies in collaboration with internal and external Health Home stakeholders.
Essential Duties and Responsibilities:
The Driscoll Health Home Coordinator is a clinical professional with a focus on operational, business and clinical metrics demonstrating effectiveness of the Driscoll Health Home program. The incumbent will participate in both clinical and operational processes and work towards improving provider and member services and outcomes in all Driscoll Health Plan Health Home projects. This should be accomplished through analysis and generation of data, collaboration with colleagues, direct and indirect project oversight, and active participation to improve program outcomes. An essential component of this position includes travel to the offices of Primary Care Providers that are contracted with DHP as Health Homes. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; the employee will perform other reasonably related business duties as assigned by the immediate supervisor, program medical directors, and health plan administration.
Education and/or Experience:
Certificates, Licenses, Registrations: