Description
This is a 6 month temporary position-not benefit eligible
Hours: 20+ hours a week
Under the direction of the AVP for Quality Improvement, the Population Health Coordinator (PHC) supports the organization’s efforts to improve quality data capture in the Electronic Medical Record and conducts patient outreach to engage patients in care to address their care gaps. The PHC is focused on improving data capture of relevant patient screenings, results, and services to prepare the organization for submission of UDS+ reporting in 2025.
Responsibilities
The Population Health Coordinator plays a key role in the Health Center’s UDS+ Improvement initiative by working closely and routinely collaborating with Quality team members, Medical Assistants (MAs), Nurses, Providers, and operations staff to track care and maintain accurate data in the EHR. Key duties include:
- Leverages available information and reports from the current Epic electronic health record (HER), the legacy EHR (Athena Practice) and population health platforms, including Arcadia, to locate missing patient care gap data and outside results. Examples include and are not limited to colonoscopies, diabetic retinal exams, mammograms, and external lab results (HbA1c, Cologaurd, PAP smears/HPV testing)
- Accurately records care gap data and external results into the Epic EHR to ensure structured data is captured for UDS+ reporting.
- Appropriately updates Health Maintenance Care gaps based on care gap data located
- Initiates outreach to patients via reminder letter, telephone call, or MyChart message to schedule appointments and remind patients about overdue care, including procedures, lab tests, and appointments related to quality metrics
- Addresses patient replies to outreach campaigns appropriately and in a timely manner
- Utilizes motivational interviewing skills, as necessary, to appropriately engage patients, directing and receiving support from the clinical care team(s) when necessary
- Documents outreach and other notes in the EHR and other databases to document outreach and to communicate to clinical and teams information about care that is due for individual patients
- Documents measure exclusions in excel for patients within value based care contracts for submission to BILHPN
- Tracks outreach efforts and audit activities and provides summary progress reports to leadership
- Generates and distribute patient registry reports, as needed.
- Conducts chart audits for data validation and to identify opportunities for improvement.
- Conducts chart audits for referrals, test tracking and lab/imaging tracking and implements protocols to administratively close the loop for tracking, as appropriate
- Adheres to all agency and departmental policies and procedures
- Upholds the principles of customer service in all interactions with all co-workers, patients, and external stakeholders
- Participates in additional quality assessment and improvement activities as requested
- Adheres to the highest principles of patient and client confidentiality
- Adheres to established safety policies, procedures and precautions; identifies potential or actual unsafe situations in the environment and informs appropriate staff
- Attends all required meetings, in-services and professional trainings
Requirements
Performs related duties as required
- Strong Electronic Medical Record skills, including medical terminology and understanding of clinical quality data
- Highly organized and self-motivated individual with the ability to work autonomously
- Well-developed analytic and writing skills required
- Ability to work harmoniously and effectively with colleagues, patients, clients and vendors across the spectrum of diversity, including but not limited to race, ethnicity, color, gender identity, sexual orientation, age, socio-economic status, national origin and immigrant status, religious or spiritual identity, disability (physical, mental, emotional and developmental), veteran status, and/or limited English proficiency.
- Willingness to contribute towards Fenway’s efforts in becoming an anti-racist organization and promoting a culture dedicated to ongoing development in service of humility, equity, diversity, inclusion, and belonging, where differences are acknowledged and valued.
- Proficient in MS Word, Excel, and PowerPoint.
Preferred Qualifications
- Epic medical record experience
- Clinical training/background
- Training in motivational interviewing
- Working knowledge or familiarity with electronic health records and other health care IT systems
- Working knowledge of clinical quality metrics such as HEDIS NCQA or UDS metrics
- Patient-focused experience or customer service background
- Fluent in Spanish
This is a union position in a Fenway Health bargaining unit represented by 1199 SEIU United Healthcare Workers East.
LGBTQIA+ identified persons, Black, Indigenous, and other people of color (BIPOC), and individuals from other historically underrepresented communities are strongly encouraged to apply.