Population Health Specialist

Overview

The Population Health Specialist provides clerical and data support for value based care initiatives.  This position assists with both clerical and analytical functions of all value-based quality improvement projects. The Population Health Specialist is expected to effectively communicate outcomes and results, as well as design and create dynamic presentation materials. They are responsible for coordinating meetings, record-keeping, and tracking improvement initiatives.

Responsibilities

SUMMARY OF RESPONSIBILITIES:

This position provides support to the Population Health Director by:

These include, but are not limited to:

• In collaboration with the Population Health Director to ensure Plans meet clinical standards of care and achieve the desired outcome for UHC for Health Effectiveness Data and Information Set (HEDIS), and HEDIS STARS.

• Work with leadership to improve the overall Risk Adjustment Factor (RAF) score of the Medicare and Medicare Advantage members.

• Work with Health plans and Population Health platforms.

• Competency in gathering information and understanding context from several sources, with the ability to analyze this information and draw conclusions.

• Work with other departments to maximize quality metrics and financial ROI across all value- based programs.

• Provide feedback and collaborate with EHR and data teams to ensure reports are accurate, meaningful, and actionable.

• Coordinating tracking and reporting of clinical outcomes and follow-up of corrective action plans from contracted Independent Physician Associations (IPAs) and Health Plans

• Identifying gaps in care for patients with complex health needs to ensure that they receive appropriate follow-up care from specialists or other providers.

• Assist in educating and training UHC staff on value-based initiatives and UHC’s quality patient measures.

• Assist in general clerical/office duties associated with the department.

PERFORMANCE AREA 1

• Schedules and organizes complex activities such as meetings and department activities.
• Performs desktop publishing. Creating and developing visual presentations for the quality improvement activities.
• Establishes, develops, maintains, and updates the filing system
• Organizes and prioritizes information and calls
• Responds to regularly occurring requests for information.
• Types and designs general correspondence, memos, charts, tables, graphs, business plans, etc. Proofreads copy for spelling, grammar, and layout, making appropriate changes. Responsible for the accuracy and clarity of the final copy.
• Works closely with onsite performance improvement teams to design, implement, and monitor quality improvementinitiatives.
• Attends and actively participates in all meetings (e.g., department meetings, program meetings, employee staff meetings) and other activities as required or assigned.
• Attends workshops/seminars as necessary to increase skills and knowledge to provide effective  care, treatment, and/or leadership.
• Supports the overall needs of the department by working flexible or extended hours when necessary.
• Supports the needs of the health center by traveling to other UHC health centers when department needs dictate.
• Demonstrates awareness of, and compliance with, the organizational mission and objectives of UHC to provide health care access and support services for all members of the community.
• Other work-related duties as assigned by supervisor.  
• Maintains confidentiality and respect for information regarding patients and other team members;  abides by UHC Rules of Confidentiality and general HIPAA regulations regarding privacy.

• Displays a positive, professional, and respectful demeanor at all times toward employees, peers, professional contacts, and patients served, maintaining a professional appearance and positive image for the health centers.

• Contributes to the team by promoting positive staff interaction and maintaining open communication with other  programs/departments.

• Researches, tabulates, and prepares program performance information.

• Maintains detailed knowledge of federal, state, local, and internal rules, regulations, policies, and procedures governing  UHC programs

Qualifications

QUALIFICATION REQUIREMENTS:

EDUCATION:

• AS/AS or equivalent required. Bachelor’s Degree preferred.
• Degree/certification in healthcare related field preferred (e.g., BS in Health Education, Medical Assistant certification).

PRIOR EXPERIENCE:

• 1 or more years of clerical experience or experience in a health care setting
• Value-based experience

SKILLS: 

• Experience with HEDIS or value-based clinical performance measures
• Comfortable understanding of Code sets (e.g., CD 100, CPT, CDT, etc.), especially Hierarchical Condition Category (HCC) coding.
• Comfortable understanding of Risk Adjustment Factor (RAF) scores
• Advanced Word/Excel PowerPoint experience

• Competency in gathering information and understanding context from several sources, with the ability to analyze this information, draw conclusions, and make recommendations, is required.

• Exceptional written and verbal communication skills with peers, executives, and other key stakeholders are required.

• Must demonstrate advanced problem-solving skills and exceptional attention to detail.

• Must be flexible and maintain positive working relationships with the ability to comfortably navigate ambiguity, significant autonomy, and a fast-paced, changing environment

• Must have strong project management and prioritization skills combined with the ability to ensure sensitive timelines are me

• Exceptional written and verbal communication skills with peers, executives, and other key stakeholders are required.

• Able to quickly build and maintain rapport with staff of differing backgrounds; team player
• Customer-service oriented
• Positive professional insight
• Strong writing and verbal skills
• Flexibility and dependability
• Demonstrated good problem-solving skills; sound judgmentil
• Attention to detail and excellent follow-through on work tasks
• Able to handle multiple tasks simultaneously

PHYSICAL REQUIREMENTS:

• Must be able to lift up to 20 pounds and push up to 50 pounds (on wheels).
• Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to patients and staff.
• Must be able to read memos, computer screens, personnel forms and clinical and administrative documents.
• Must have high manual dexterity.
• Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouch, reach, kneel, twist/turn

The hourly wage range that UHC reasonably expects to pay for the position upon hire starts at $23.10 an hour. Our salaries are dependent on knowledge, skills, and experience.

In addition, our comprehensive benefits package for regular status employees includes:

• Medical, Dental, and Vision insurance with low premium cost
• Paid time off and paid holidays
• 401k plan with matching contribution
• Educational Assistance
• Employee discounts and more!