Performance Liaison

SUMMARY:

The Performance Liaison works in collaboration with physician practices to target opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance. Responsible for managing Medicaid ACO Model B Quality Programs 13 measures in 3 domains (Preventative and Pediatric Care/Care Coordination/Care for Acute and Chronic Conditions/Member Experience) by working with low performing providers to identify areas of opportunity. The Performance Liaison will be the main ACO Group Quality contact for providers, they will provide guidance and resources in order for the provider to achieve target Quality Performance metrics, as established by Masshealth.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

RESPONSIBILITIES:

• Works in collaboration with provider offices to target opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance. Maintains collaborative relationships with peers and colleagues in order to effectively contribute to the working group's achievement of goals, and to help foster a positive work environment.

• Evaluates provider and office staff workflow to identify opportunities for workflow improvement and is responsible for developing and implementing process improvement to enhance provider and staff workflow.

• Completes medical record data review/collection for appeals and exclusions at the time of data submission per contractual obligations. Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment and HEDIS measures.

• Interacts with and provides providers and office staff best practices and workflows regarding billing and documentation policies, procedures, and conflictingmbiguous or non-specific documentation.

• Responsible for monitoring provider performance and reporting to BUH/Hawthorn management to track and share data with practice on performance against goals, escalating any issues at the practice level in a timely manner.

• Report on quality measures, evaluate strengths and weaknesses, and address workflow deficiencies.

• Works collaboratively with assigned Performance staff, Office Managers, and practice staff to coordinate improvement efforts related to overall performance. Implements performance improvement plans at the practice level.

• Produces and maintains record by keeping documentation up to date and reporting progress on a weekly basis. Provides dashboard reports to providers, practices, and recommendations on improvement.

• Educates providers and leadership on clinical indicators to capture the severity of illness of the patient. Develops and delivers training materials (Provider and Practice-Facing). Provides leadership and staff with training, on-site collaboration and on-going performance reporting.

• Responsible for managing Medicaid ACO Model B Quality Programs 13 measures in 3 domains (Preventative and Pediatric Care/Care Coordination/Care for Acute and Chronis Conditions/Member Experience) by working with low performing providers to identify areas of opportunity.

REQUIRED QUALIFICATIONS:

• High school diploma or equivalent plus additional training in clinical health care field of study.

• Medical Assistant or LPN license preferred or equivalent clinical experience.

• 2-3 years of physician practice experience preferred in a pediatric or family medicine environment.

• ICD10 coding experience preferred.

• Experience in quality measures preferred.

SKILLS AND ABILITIES REQUIRED:

• Knowledge of quality metrics and risk adjustment.

• Required to attend meetings as necessary.

• Ability to manage projects and work with multiple priorities.

• Ability to organize and prepare training materials, conduct in person and computer-based training.

• Ability to use technology effectively with basic Microsoft product proficiency.

• Ability to work under pressure and demonstrate a strong sense of diplomacy and

• Ability to work independently with excellent written and oral communication skills, organization skills, and attention to detail.

• Ability to demonstrate strong interpersonal and communication skills; able to effect areas of opportunity to providers and practices as well as leadership.

WORKING CONDITIONS:

• While performing the duties of this job the employee is frequently required to walk; stand; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; and talk or hear. The employee is occasionally required to sit or stand. May be exposed to various patient conditions including infectious diseases, blood, and bodily fluids. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

SUPERVISORY RESPONSIBILITES
None.

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EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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