Clinical Facilitator – Quality

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We are seeking an enthusiastic Clinical Facilitator – Quality for our Value Based Care department. This position is for a trained healthcare professional who facilitates the improvement of patient’s quality of life by helping bridge gaps in preventive care measures to prevent diseases or disease progression.

Key Responsibilities:

• The primary responsibilities of the Clinical Facilitator include registry building and maintenance.
  • Patient Initial Identification Responsibility (Using eligibility criteria, exporting data from EHR, importing data into the native population health management software/quality excel sheet).
  • Ensure entry of quality care gaps from EHR is consistent, accurate, and appropriate per workflow requirements and documentation standards to support quality healthcare delivery to CMS and the assigned practice or client.
  • Meet or exceed daily targets of quality care gaps according to MIPS, HEDIS and STARS guidelines provided in the training. Annual completion of GPRO as required by CMS.
  • Record ineligible patients per procedures.
  • Review the care gaps as needed, assess the patient for eligibility, closure (through identifying closed gaps/assigning the closure task to the appropriate care team and follow up to ensure closure).
  • Maintain records for all aspects of PCM (unable to reach patients list, refused patients list, missing documents of patients list).
• Quality Reports:
  • Review quality reports daily to correct any errors and minimize future occurrences.
• Additional Responsibilities:
  • Update patient health information, insurance, and eligibility for quality care gaps per procedures.
  • Ensure the quality of work meets Company standards.
  • Responsible for building effective relationships with other team members.
  • Actively participating in development opportunities.
  • Comply with Company’s policies, procedures, and healthcare laws and regulations.
  • Ensure all immediate concerns and requests are being raised in real time.
  • Assist with other duties as needed.
• Any other related task by the manager or reporting line.

Professional Qualities/Skills

Technical Skills:

• Computer literacy and document management (Excel and e-files)

Soft Skills:

• Understanding of medical terminology.
• Excellent verbal and written communication and interpersonal skills are required