Population Health Care Quality RN

CommonSpirit Health - Phoenix, AZ

Job Title: Population Health Care Quality RN

Position: Managerial oversight of managed care incentives programs

Job Type: Full Time

Pay: $35.28 - $51.16 /hour

Shift:

Work Type: On-Site

Location

Address:

City: Phoenix

State: AZ

ZIP Code:

Job Responsibilities

Provide managerial oversight of managed care incentives programs (e.g. quality/HEDIS/PCMH) to maximize incentive capture.
Coordinate with medical directors, regional directors, and clinical pharmacists within incentive programs.
Serve as a liaison to hospital case management to facilitate care coordination post-acute to the transitional care clinic.
Identify gaps in care via data mining EHR and facilitate patient appointments and appropriate follow-up (mammo, HTN, DM, etc.).
Oversee PCMH and manage monthly PCMH meetings.
Act as ACN liaison and contact for navigator to prevent attribution loss.
Possess significant knowledge of quality metrics: Ambulatory, Acute Care, PCMH, ACN, and payor population health incentives.
Serve as leader and/or member of multi-functional, multi-department project teams to provide direction in the development, management, and implementation of hospital initiatives.
Provide focused management of projects, initiatives, and tasks designated as priorities with specific attention to activities relating to new business implementations and other new business requirements.
Develop standardized processes, tools, methodologies and presentation templates, including project timetables, progress/milestone reports, financial reports, resource issues and benefits tracking.
Identify potential project risks and implement appropriate courses of action to address project slippage and develop strategies to mitigate future risk.
Escalate critical issues for appropriate/timely resolution as needed.
Maintain regular contact with senior project sponsors and coordinate program efforts with other key stakeholders (e.g., Finance, IT, HR, etc.).
Analyze, apply, interpret, and communicate policies, procedures, and regulations effectively to meet licensing and accreditation requirements.
Perform other duties and responsibilities as requested.

Required Skills

Core Skills

Significant knowledge of quality metrics
Effective communication skills
Detail oriented
Able to focus on multiple hospital and system operations
Ability to analyze, apply, interpret and communicate policies and procedures

Preferred Skills

Experience with MIPS Ambulatory Quality
Knowledge of Ambulatory Regulatory Standards
Experience working with Microsoft Project or other Project Planning software
Knowledge of hospital operations and planning ability

Requirements

Experience: 5 years working in an Ambulatory/Acute Care environment including PCMH, ACN, Payor Population Health Incentives and with quality metrics

Education: Bachelor's Degree or equivalent combination of education and experience

License & Certification:

AZ RN license

Schedule:

COVID-19 Requirements: Not Specified

Benefits

Not specified

Supplemental Pay

Not specified

Special Notes

Must reside in Arizona
Tobacco-free campus

Facility Details

Name: CommonSpirit Health

Description: Dignity Health Medical Group (DHMG) employs approximately 400 providers and 1200 support staff that cover a wide variety of specialties, providing more than 73 subspecialty services.

Specialties:

Healthcare
Clinical services
Medical education
Research

Mission: The mission of Dignity Health Medical Group is consistent with Dignity Health’s mission and St. Joseph's guiding principles with a focus on innovative clinical care and the pursuit of excellence through scholarly activities.