Value Based Population Health Manager in North Charleston, South Carolina at FETTER HEALTH CARE NETWORK INC

POSITION SUMMARY

As a part of Fetter Health Care Network's (FHCN) patient centered medical home the Value Based Care (VBC) Manager is accountable for the development, leadership, and oversight of the organizational QI/QA Plan; to include the planning and oversight of quality initiatives. The manager will collaborate with senior leadership and other department leaders in the development of organizational strategic plans, quality improvement strategies, and controlled/sustainable plans. He/she will ensure optimal interdepartmental communication, with a focus on efficiency and effectiveness. He/she will be accountable for the oversight and leadership of the Quality Improvement Program, to include partnering with Risk Management and Compliance and PCMH Director. The manager is accountable for the ongoing review of all VBC contracts, and communicating relevant performance indicators, thresholds, and data with organizational stakeholders. The manager is accountable for the oversight of thorough, timely, ongoing/recurring reporting processes and the correlating data sharing with organizational stakeholders (including UDS, HEDIS, PCMH, MU, etc.) The manager is accountable for the ongoing tracking and trending of Care Gaps and ensuring adequate organizational processes are in place to rectify care gaps in accordance with evidence-based guidelines. He/she is accountable for ongoing collaboration with organizational financial leadership regarding financial earning potential related to VBC contract(s) terms and conditions, ongoing tracking, and trending of performance indicators/metrics, and reporting financial opportunities.

ESSENTIAL DUTIES AND RESPONSIBILITIES (Included but not limited to the following).

Program Manager - 80%

Departmental Responsibilities

• Leads and provides oversight of staff, ensures appropriate scheduling, resource allocation and evaluation of work products/activities of Quality Dept.
• Leading a culture of continuous quality improvement through the creation of value across the Quadruple Aim
• Continually seeks, identifies, recommends, and implements quality improvement initiatives.
• Maintains awareness of advances in nursing/medicine and technology, and regulatory changes etc., relevant to evidence-based care delivery.
• Development of data strategy to achieve goals of Quality and VBC programs.
• Serve organization in capacity of subject matter expert/superuser in Health Information Technology platforms and programs.

Interdepartmental Responsibilities

• Encourages and models open communication between staff and other departments, ensuring effective interdepartmental functioning. Makes recommendations as appropriate.
• Works with other departments to establish goals and initiatives to influence the Quadruple Aim
• Reviews facility activities and data to aid risk management and to improve service utilization, including maximizing use of available resources.
• Oversees and documents monthly in-service trainings for Providers and clinical staff.
• Leads and/or participates in organizational committees such as: QI/QA Committee, CIMS, SCPHCA
• Collaborates with IT/HIT support teams to ensure system performance in support of clinical and non-clinical workflows.

Delivery of Medical Care/Clinician Services - 20%

· Provides direct patient care to clinic patients as an active member of the medical team.

· Interviews patients to obtain history, perform physical examination, order lab and other tests, prescribing medications, and treatments.

· Performs a physical exam of each referred patient in accordance with Clinic guidelines.

· Prescribes an appropriate treatment plan for each patient in accordance with choices made by the patient, unless medically contraindicated.

· Provides information requested by the clinic for its medical records to allow appropriate follow-up of each client using electronic medical records systems.

· Ensures that all medical complications are followed according to satisfactory referral processes.

· Serves in rotation for after hour call coverage, performing medical procedures according to privileges issued.

· Makes referrals for secondary and tertiary care.

· Providing health maintenance visits, evaluating-for immunizations, and providing anticipatory guidance and referrals; performing contract and special physical examinations as EPSDT, employment, etc; performing STD (sexually transmitted disease) and family planning screening and education.

· Documenting all patient contact accurately via the Health Center's Electronic Medical Records system.

EDUCATION and/or EXPERIENCE:

· Medical degree (RN, MD, DO, PA, or NP) from an accredited academic institution.

· Valid Drivers' License.

· Must meet all credentialing requirements for Medicaid, Medicare, and insurances.

· Five + years practice in medicine in an outpatient primary care environment.

· Five + years of managerial experience preferred.

· Experience in a Federally Qualified Health Center strongly preferred.

LICENSURE:

• Current South Carolina Medical Licensure/Certification (in good standing/without restriction) as related to professional degree/educational background.
• Basic Life Support (BLS) Certification

KNOWLEDGE, SKILLS, AND OTHER ABILITIES:

• Excellent attention to detail
• Excellent interpersonal skills
• Ability to work with complex computers and machinery.
• Must be a team player.
• Excellent customer service skills