Population Health Clinical Quality and Risk Liaison

St. Luke’s Health is the largest Catholic health system in greater Houston and southeast Texas. Our integrated delivery network comprises sixteen hospitals covering Houston, Brazos Valley, southeast Texas and Lake Jackson, and East Texas and Lufkin, and includes Baylor St. Luke’s Medical Center, the research and teaching hospital for Baylor College of Medicine. St. Luke’s Health is home to the Texas Heart ®Institute (THI), the top ranked heart center in Houston, and the Dan L Duncan Comprehensive Cancer Center, a nationally ranked NCI designated cancer center. Our integrated network of care includes more than 398 employed and 1,668 clinically aligned network providers, and more than 20,000 employees delivering high value, nationally ranked quality and compassionate care along with our Christian ministry of healing.  Our goal is to deliver accessible, nationally recognized high quality care through the highest valuenetwork for choice in healthcare for patients, employers and payers with a commitment to an equitable and personalized patient experience for all consistent with our ministry of healing.

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.