Quality Care Coordinator - Value Based Care

JOB SUMMARY

SUMMARY:

The LSU Healthcare Network is a non-profit, academic, multi-specialty healthcare delivery system dedicated to patient care, research, and education. You can be a part of a progressive healthcare team making a meaningful difference in the care of patients. The LSU Healthcare Network is made up of over 175 healthcare providers - from primary care to specialty care - at several multi-specialty care locations in and around the Greater New Orleans area. We offer a competitive compensation and benefits package, including: 15 PTO Days 11 Paid Holidays 401(k) Plan with employer match Health Insurance Tuition ReimbursementPOSITION PURPOSEThe Care Coordinator is responsible for ensuring patients' experiences with the LSU Healthcare Network are seamless and comprehensive. The Care Coordinator will review, plan and coordinate health care services in order to utilize appropriate processes and appropriate resources to improve members' health outcomes. The Care Coordinator will use clinical and organizational knowledge to perform on-going assessment, identify gaps in care, recognize problem identification, recognize referral opportunities, and provide education and follow-up in order to coordinate care and improve patient outcomes. PRINCIPAL RESPONSIBILITIES:

• -------- Utilize effective population health management tools to increase quality outcomes and decrease healthcare costs across all value-based contracts
• -------- Develop and implement effective care management protocols and workflows consistent with evidence-based guidelines, practice resources, and systematic workflows to enhance patient care
• -------- Engage, educate, and assist physicians and staff in quality improvement and HEDIS metrics to improve patient outcomes
• -------- Assist in the CMS Quality Payment Program (QPP) for over 800 physicians across the state
• -------- Assist in reporting monthly quality metrics and current HEDIS, Star, and Risk scores to physicians and staff
• -------- Work with payers to outreach to patients with gaps in care
• -------- Guide the patient throughout their entire experience - from the initial outreach phone call to closing referral loops, missed appointments, etc.
• -------- Assists patients with scheduling appointments for testing, treatments, follow-up, office procedures, etc. and assists in obtaining authorization and/or providing appropriate documentation for referral/appointment
• -------- Ensures results of testing, treatments, office procedures, etc. are received, reviewed and documented in member record accurately and in a timely manner
• -------- Actively follows-up on concerns or problems until resolved, and communicates resolution to patient and physician(s)
• -------- Reviews HEDIS/STAR/RISK reports and Care Gaps at least monthly with the Director of Quality in order to coordinate an action plan for improved measure performance and patient outcomes
• -------- Performs other job related duties as requestedCORE COMPETENCIES
• -------- Professionalism
• -------- Strong verbal and written communication skills
• -------- Planning and organizational skills
• -------- Highly developed sense of integrity and commitment to customer satisfaction
• -------- Conflict management and resolution
• -------- Manages time appropriately/efficiently/effectively
• -------- Excellence with interpersonal relations
• -------- Ability to work independently and proactively, and make decisions
• -------- Ability to handle multiple demands of diverse workload and prioritizes critical issues
• -------- Ability to effectively interact with multifaceted providers, medical professional staff, and insurance payersExperience/EducationHigh School diploma or GED equivalent requiredLA LPN license or Medical Assistant Certificate preferredMinimun 2 years clinical experience in a patient care environment requiredExperience in Value-Based care preferredKnowledge and experienced in computer skills, particularly Microsoft Office products and Electronic Health Records-