Process Improvement Spec II Position Available In Monroe, New York

Process Improvement Spec II University of Rochester – 3.9 Rochester, NY Job Details Full-time $26.90 – $37.66 an hour 2 days ago Qualifications Microsoft PowerPoint Microsoft Word Microsoft Excel Microsoft Outlook Primary care Mid-level NCQA standards Pivot tables Data collection Associate’s degree Communication skills Time management Full Job Description As a community, the University of Rochester is defined by a deep commitment to Meliora – Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): 135 Corporate Woods, Suite 200C, Rochester, New York, United States of America, 14623

Opening:

Worker Subtype:

Regular Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

500912

Primary Care Administration Work Shift:

UR – Day (United States of America)

Range:

UR URG 109 H

Compensation Range:

$26.90 – $37.66 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

GENERAL SUMMARY

Primary care population health focuses on supporting population-level care for patients attributed to UR primary care practices. Population health encompasses (a) quality initiatives to improve population-level health metrics, specifically focused on the pay-for-performance programs, (b) NCQA’s Patient-Centered Medical Home (PCMH) to optimize care delivery, (c) assessment of Hierarchical Condition Category (HCC) codes to optimize revenue, and (d) other measures to optimize quality and contain costs. Together these initiatives illustrate the growing importance of value-based contracts in which UR Medicine receives incentive or per-member-per month payments to improve the health of the population we serve. Under general direction and with latitude for independent judgement and initiative, the Program Coordinator of PCMH and Value-Based Payment (VBP) will help support population health initiatives across the URMC enterprise. This position will operate as the providing program coordination support for NCQA’s PCMH recognition program and payer VBP programs through monitoring, analyzing, and implementing workflows. To achieve success under these programs, UR Medicine requires an orchestrated approach with a sharp focus on performance at the Tax Identification Number (TIN) level. As a result, the Program Coordinator of PCMH and VBP will work across all eight primary care entities – UR Primary Care Network, Highland Family Medicine, Strong Internal Medicine, Strong Pediatrics, the Medicine in Psychiatry Program (MIPS), Geriatrics and Medicine Associates (GAMA), the Complex Care Center (CCC), and St. James Hospital. Reporting to the Director, Practice Transformation, this role will be responsible for in-depth knowledge of detailed, program-specific requirements for both NCQA’s PCMH and VBP programs.

ESSENTIAL FUNCTIONS

Serve as liaison for United Healthcare MCAIP/MAPCPi program workflows to achieve superior performance. Recommend best practices, produce training materials and track performance throughout each program year. Participate in central review to assess UHC suspect conditions. Support practice teams (providers, nursing, care managers) in identification and closure of gaps in care related to pay for performance programs. Maintains knowledge of practice operations and procedures across various departments and has the ability to effectively participate in recommending and planning process improvements. Serve as a trainer/coordinator of new VBC program processes at Primary Care practices throughout URMC Responsible for uploading and submission of evidence to payers at the direction of the program manager (through portals or alternative methods) to maximize performance in pay for performance programs (including but not limited to: UHC, MVP, Fidelis etc.) Directly supports program coordination for the

URMC PCMH

Program Assists with ensuring compliance with PCMH standards through intra-cycle monitoring processes Assists with patient chart audits required for an application on an as-needed basis Assists with the yearly completion of PCMH annual report submission into NCQA portal (Qpass) Assists with maintenance of Qpass and ensuring accurate provider information at all times Monitor and maintain attribution files from the payers for reconciliation against internal data with direction from the Program Manager When needed, confidently and clearly communicate data discrepancies (including patient attribution, gap closure details etc.) to payer representatives to resolve error in an effort to optimize funds flow and work flow efficiencies Responsible for maintaining expert knowledge of eRecord functionality related to primary care dashboards, reporting capabilities and eRecord patient chart audits. Leverage this knowledge to benefit the PCMH and VBP programs to utilize information towards PCMH applications and to compare internal data vs. external insurance reports. Ability to analyze and interpret data trends and produce reports Learning and understanding VBP programs and maintaining familiarity with NCQA’s PCMH Standards and Guidelines Other duties as defined

MINIMUM EDUCATION & EXPERIENCE

Associate’s degree required. Or equivalent combination of education and experience required.

KNOWLEDGE, SKILLS AND ABILITIES

Quality data collection and reporting experience preferred. Experience in primary care department preferred. Experience with Epic (electronic medical record) preferred. Excellent organization, time management and problem-solving skills preferred. Ability to think critically and independently while handling multiple priorities preferred. Intermediate MS Outlook, Word, PowerPoint and advanced MS Excel are required preferred. Competency in pivot tables desirable preferred. Excellent communication skills (verbal and written) with ability to facilitate meetings as needed preferred. Ability to travel to practice locations preferred. The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.