Population Health Specialist

Where You’ll Work

Located in Lakewood, Colorado, St. Anthony Hospital is a Level I Trauma Center where we provide a full range of medical specialties and health care services to Denver and the surrounding region through our state-of-the-art medical campus and home base for Flight For Life® Colorado. With four trauma rooms including the T-10 room, a dedicated field-to-surgery suite ready 24/7 for trauma surgeons and specially trained teams, our staff can provide life-saving care to the most severely ill and injured patients. In 2023, we received our exciting Magnet® designation! We are so proud of our staff for this achievement, which is awarded to only 10 percent of hospitals around the world. Numerous other awards, certifications, and accreditations have been granted to us from the American Heart Association; Chest Pain Center (CPC); American College of Cardiology; The Joint Commission’s National Quality Approval; the Emergency Nurses Association Lantern Award; NAPBC Accreditation; American College of Radiology and many others. At St. Anthony Hospital. We combine a heritage of expert care with the latest in technology and innovation. If you’re looking to be part of a fast-paced environment where you can practice to the top of your profession in trauma, cardiology, stroke, neurosciences, breast imaging, cancer/oncology care, surgery and more, we invite you to apply.

Job Summary and Responsibilities

As our Population Health Specialist, you will leverage your knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) quality metrics to close documentation gaps for payer programs, using patient electronic medical records and clinic data to enhance health outcomes.

Every day you will manually review medical records for care gap completion, update patient electronic medical records, conduct manual care gap closures via internal payer attestation, and proactively identify patient record needs. You will also provide support and education on network platforms, track and report gap closures, participate in payer meetings, develop training materials aligned with National Committee for Quality Assurance (NCQA) guidelines while collaborating with internal associates and payer resources to manage patient attribution.

To be successful in this role, you will possess strong analytical skills rooted in HEDIS quality metrics, meticulous attention to detail in medical record review and data management, the ability to develop trusting relationships with providers, and a proactive approach to continuous process improvement to drive quality performance and patient outcomes.

• Through internal payer attestation processes, conducts manual care gap closures for records that have been completed and adequately documented.
• Manually conducts a review of patients’ medical records seeking evidence/supporting documentation of care gap completion.
• Provide support and/or education on the utilization of network platforms or electronic health records where primary care practices can review quality and utilization performance and pull patient rosters and gaps of care.
• Identifies opportunities to improve current processes and workflows through chart reviews and observation that will enable providers and care teams to focus on care provision and to provide the highest quality care to patient populations.
• Collects, tracks, reports, and communicates data and data analyses as required.
• Develops quality training materials that align with NCQA guidelines.

Job Requirements

Required

• High School Diploma or GED
• Experience with building training materials and training staff
• One (1) to two (2) years of experience with lean or six sigma methodologies
• Proficient in use of computer applications

Preferred

• Bachelors Degree in healthcare
• Two (2) to three (3) years healthcare experience in an outpatient medical practice
• Experience with electronic medical records
• Experience with payer quality programs