Manager of Population Health - Baltimore, United States - Total Health Care (MD)

    Total Health Care (MD)
    Total Health Care (MD) Baltimore, United States

    1 month ago

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    Description
    Total Health Care, Inc.

    Job Class Specification/Job Description

    **

    Only Registered Nurse candidates will be considered *** Title:

    RN Manager of Population Health


    Grade:

    TBD

    FLSA:
    (Exempt)


    Financial Disclosure:
    May be required to file

    Job Summary


    Under supervision of the Director of Population Health, Quality and Patient Safety, the Manager of Population Healthleads a multidisciplinary team to improve health outcomes of patients, and meet or exceed quality metrics and value-based reimbursement benchmarks.

    This position is responsible for implementing, monitoring, and evaluating daily operations of the department. This position will also be responsible for participating and leading continuous quality improvement activities.

    Essential Duties
    Oversees the daily operations of The Population Health Department.

    Review daily Managed Care Organizations (MCO) Patient Panel Database identifying patients with chronic disease, frequent emergency room, hospital admissions, new patients and patients with gaps in care and loss to care.

    Daily ensure the team is contacting patients with chronic disease, frequent emergency room, hospital admissions, new patients, patients with gaps in care, loss to care, or new to care.

    Ensure the team is contacting patients to schedule appointments.

    Ensure the team is providing health education, tracking internal and external referrals and, serving as a liaison to the patient.

    Assist the team with contacting patients and chronic care management as needed.
    Submit daily, weekly and monthly reports tracking progress of team and MCO Patient Panel Database.
    Review trends and analysis data, developing summary of findings.
    Conduct chart audits on a regular basis ensuring preventive and chronic care task have been completed on time.
    Track "No Shows" and ensure follow-up is completed
    Follow up with internal teams to discuss trends and develop strategies to improve patient engagement, clinical and financial outcomes.
    Monitor on a daily basis referral tracking.
    Ensure all required documentation is completed as required.
    Collaborate with Director and VP of Population Health, Quality and Patient Safety to identify population management priorities and interventions.
    Participation in continuous quality improvement initiatives.
    Assist with training of departmental staff and clinical staff.
    Collaborate and support other departments on outreach events.
    Other duties as required
    Required Certifications, Licenses, Registrations

    Valid Maryland Registered Nurse
    Valid Maryland State Driver's License

    Preferred Education:
    Certification in Chronic Care Management and/or Care Management
    Bachelor's Degree in Nursing
    Public Health or Health Related Field.

    Required Experience:

    2+ years Care Management/Case Management Experience
    3+ years previous experience in a health clinic setting required.
    Microsoft Office, Electronic Medical Record System

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