SHS-POPULATION HEALTH QUALITY SPECIALIST-MED ASST

Population Health Quality Specialist

Positions Location: Lansing, MI

Job Description

General Purpose of Job:

As a member of the Population Health Service Organization (PHSO), the Population Health Quality Specialists (PHQS), will play an important role in redesigning the care provided for Sparrow Care Network (SCN). Serving both the employed, Sparrow Medical Group (SMG) primary care practices and the independent offices, the PHQS will be responsible for contract performance with a subset of the population. Tasks could include chart review/chart prep, review of quality metrics, outreach to patients needing an annual visit, and ongoing review of metric performance.

This position will work on-site at the PHSO office, providing ongoing telephonic support for the practices. It will be essential that the PHQS possess a strong understanding of scheduling workflows, be comfortable communicating to all team members, and have a sense of adaptability working offsite and supporting multiple practices.

Essential Duties:

• Works with the internal Program Development team to understand prioritized tasks, participating in daily huddles
• Provides prompt outreach to the assigned patients, while thoroughly documenting the conversation for team updates
• Meticulously reviews the Electronic Medical Record (EMR) to assist in closing gaps in care
• Understands the basic principles of risk capture, clearly identifying opportunities around Hierarchical Condition Categories (HCCs)
• Coordinates care with the primary care practices for patients that need to be seen
• Problem solves with patients to maximize their ability to follow preventative recommendations
• Develops and maintains an effective professional working relationship with all patients, families, Physicians, Advanced Practice Providers (APPs) and additional care team members
• Arranges education and referrals as needed for patients and families
• Screens selected cases to identify needed services and interventions to deliver quality comprehensive care that addresses the patient's full range of health care needs
• Identifies issues, which may impact medical outcomes based on comprehensive assessments that may include the patient's medical condition, support systems, finances, living situation, housing, behavior cognition, function/abilities, and the patient's choice and/or preference
• Collaborates with other members of the Sparrow Health System (SHS) team to collect, analyze, and utilize data for quality and process improvement activities
• Works with office staff as part of an Interdisciplinary Team, develops and implements a plan which addresses problems and needs identified in the assessment and ensures continuity of care
• Acts as the initial point of contact (POC) for the centralized team, as the group researches and implements new workflows to support the practices
• Supports the development of new policies/procedures to ensure documentation is in place for the remote work
• Pilots potential programming related to contract performance, closing quality gaps in care, capturing risk, and/or better supporting the practices utilizing a structured Plan, Do, Check, Act (PDCA) framework
• Attends mandatory department and SHS meetings or trainings

Job Requirements

General Requirements:

• Completion of a nationally or internationally accredited program in self-management support concepts and techniques within 12 months of assuming this position if not completed prior to being hired.
• Certified Medical Assistant - preferred

Work Experience:

• Minimum of 1 years of medical or case management experience

Education:

• High school diploma or GED
• Completion of a Medical Assistant (MA) program

Specialized Knowledge and Skills:

• Demonstrates excellent clinical knowledge, skills and judgment
• Demonstrates excellent communication skills that include emotional intelligence, relationship building, negotiation, conflict resolution, persuasion, marketing, and patient advocacy.
• Demonstrates ability to proactively and creatively problem solve.
• Demonstrates the ability to prioritize, organize, handle many tasks simultaneously, work autonomously, and manage time.
• Demonstrates the ability to work in stressful situations and manage conflict
• Ability to work in an EMR environment
• Knowledge and demonstrated ability to collect, analyze and utilize data for process improvement - preferred.
• Experience with an EMR - preferred.
• Proficiency in Microsoft Excel - preferred.
• Knowledge of case management that includes but is not limited to health care finance, hospital and community resources, discharge planning, utilization review, utilization management, ethical case management principles and evidence-based practice concepts - preferred.

University of Michigan Health-Sparrow is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.