Population Health Clinical Quality and Risk Liaison

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center the hospital is the home of the Texas Heart® Institute a cardiovascular research and education institution founded in 1962 by Denton A. Cooley MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.

The Clinical Quality Liaison educates and supports providers and practice sites in improving clinical quality measures and closing gaps in care. Travels to provider sites and clinics 50%-75% of the workweek. The Clinical Quality Liaison provides education and training to provider organization on how to improve clinical and patient outcomes, provides information on HEDIS measures, and ensure feedback is relayed on documenting appropriate medical record
documentation and appropriate coding. Assists in resolving deficiencies impacting compliance to meet State and Federal standards for HEDIS. Supports the development and implementation of quality improvement interventions and audits.

ESSENTIAL KEY JOB RESPONSIBILITIES
• Advises and educates providers and practice staff in clinical quality measures, medical record documentation, and risk coding guidelines.
• Collects, summarizes and trends provider performance data to identify opportunities for provider improvement and closing gaps-in-care.
• Supports provider practices in coordinating gaps in care with members.
• Reports provider/clinic specific metrics. Identifies specific practice needs and barriers to clinical quality improvement. Develops action plans to address the needs and barriers in collaboration with providers.
• Performs medical record review or audits as needed.
• Document provider, clinic staff, member, and/or health plan encounters.
• Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
• Provides resources on clinical quality measures to support providers and clinic staff.
• Communicates with and researches external data sources as needed. Provides communication such as newsletter articles, member education, outreach interventions.
• Update data and maintain data integrity in the population health platforms and EHR systems.
• Performs other duties as assigned.
• Executes PHSO strategy and delivers on standards set by central function.

Education and Experience Required:

• Associate’s or Bachelor’s degree in nursing
• Required or equivalent work experience of 2 years related HEDIS record collection and measures improvement with analytical review/evaluation and / or Quality Improvement. Experience in data and chart reviews to provide consultation and education to providers and provider staff.

Licensure Required

• Registered Nurse (RN) licensure

Minimum Knowledge, Skills, Abilities and Training required:

• Supports quality improvement HEDIS measures and clinical quality initiatives.
• Participates in and represents plan at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned.
• Demonstrated skills in the areas of written and verbal communication, judgment, problem-solving, presentation and public relations.