Population Health Specialist

The Population Health Specialist is responsible for utilizing HEDIS or NQF specifications to conduct clinical quality audits, attestations, and outreach for practice clinical quality performance improvement and gap closure.

Essential Functions:

• Uses multiple Electronic Medical Record (EMR) platforms proficiently
• Conducts clinical quality audits by collecting and organizing data
• Reviews outpatient medical records, hospital records, clinical lab, and pharmacy records
• Performs attestations to improve quality metrics
• Performs outreach to external partners to coordinate timely receipt of care for patients
• Provides valuable information to external facing partners in support of improving clinical quality measures and patient care through various reports used in educational forums
• Identifies opportunities for improvement and share suggestions with leadership, coaching team, or practices
• Provides support with audit appeals research
• Responds to practice inquires in a timely and accurate manner
• Maintains confidentiality and ensures compliance with HIPAA regulations
• Other duties as assigned

Knowledge, Skills and Abilities:

• Knowledge of Electronic Medical Record systems
• Knowledge of diagnosis codes, CPT codes, and medical terminology
• Ability to learn and use new software and data tools
• Excellent written and oral communication skills
• Great customer service skills
• Teamwork skills
• Independent problem-solving skills
• Self-motivated and self-managed
• Proficient in Microsoft Office Suite

Qualifications:

• High School diploma/GED, associate or bachelor’s degree preferred
• 1-3 years’ experience as a Medical Assistant, Medical Records Technician, or Referral Coordinator
• 1-3 years’ experience working with medical records and/or patients in a healthcare setting
• Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures