Population Health Quality Coordinator

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 Quality Coordinator will assist in the promotion of quality management activities related to monitoring, assessing and improving performance in health care delivery and services to value based care patients. The Quality Coordinator is responsible for executing on strategies and interventions that enhance member participation and drive patient behaviors that improve health outcomes.

ESSENTIAL KEY JOB RESPONSIBILITIES
• Execute on local, member facing quality initiatives, designed in alignment with National and Value Hub strategy.
• Perform quality management activities related to data collection, data review, and report preparation.
• Implement member engagement strategies to increase participation in Vale Hub programs and initiatives.
• Support member quality initiatives to improve HEDIS and Stars performance.
• Conducts telephonic outreach to members to close quality care gaps for CMS Medicare Advantage Stars, Medicaid, and Marketplace Quality measures.
• Conducts telephonic outreach to members to assist in accessing and scheduling preventative services, such as screenings and annual wellness visits (AWV), drive member engagement, and enlist members in care coordination services.
• Support initiatives to drive participation in annual wellness visits.
• Request, maintain, and organize members’ medical records from contracted providers to complete analysis on areas of opportunity or critical gaps.
• Ability to navigate through patient information in an Electronic Medical Record (EMR) or a paper medical record.
• Develop an understanding of clinical HEDIS measures.
• Ability to handle various situations in a professional manner, demonstrating excellent customer service at all times, and ability to adapt to change.
• Ability to continually re-prioritize to meet the needs of internal and external customers throughout the workday.
• Maintain case files ensuring compliance with all governing regulatory agencies, document status, and resolution outcomes for each case. Maintain database tracking.
• Compose and distribute pertinent correspondence with members, vendors, providers, and other entities to maintain timeliness and accuracy standards. Gather relevant information, medical records, and other documentation to support each case.

• Willingness to work as part of a team, working with others to achieve goals, solve problems, and meet established organizational objectives.
• Must be reliable in attendance and timeliness to work.
• Executes PHSO Quality Outreach strategy and delivers on standards set by central function.
• Other duties as assigned.

Required Education and Experience:

• Associates degree or a clinical Certification, such as medical assistant preferred.
• Two or more years experience in an administrative position. Experience in health care setting and pay-for-performance or similar programs preferred. 

Required Minimum Knowledge, Skills, Abilities and Training:

• Ability to create professional documents using proper grammar, punctuation, and appropriate reading level. Awareness of clinical HEDIS measures. Ability to learn and use other software such as, QNXT, NextGen, and other electronic medical records. Ability to navigate through patient information in an Electronic Medical Record (EMR) or a paper medical record.
• Willingness to work as part of a team, working with others to achieve goals, solve problems, and meet established organizational objectives. Must be reliable in attendance and timeliness to work. Percentage Travel Required/Frequency: 50%
• Ability to handle telephonic engagement with diverse patient populations.
• Must be attentive to detail, accurate, thorough, and persistent in following through to completion all activities, demonstrating initiative for completing work assignments. Ability to communicate effectively in verbal and written form. A self-motivator with the ability to function independently.
• Extensive knowledge of Microsoft Office applications; Excel, Word, Outlook, PowerPoint.
• Statistical analysis and database skills a plus.