Job Description

Position Purpose:

The Performance Liaison works in collaboration with physician practices with opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance.

Essential Duties and Primary Accountabilities:

• Works in collaboration with provider offices to target opportunities for improved quality, risk adjustment, clinical and documentation workflow, patient experience and performance.
• Maintains collaborative team relationships with peers and colleagues in order to effectively contribute to the working group's achievement of goals, and to help foster a positive work environment.
• Evaluates provider and office staff workflow to identify opportunities for workflow improvement and is responsible for developing and implementing process improvement to enhance provider and staff workflow.
• Completes medical record data review/collection for appeals and exclusions at the time of data submission per contractual obligations.
• Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment and HEDIS measures.

• Interacts with and provides providers and office staff best practices and workflows regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation.
• Responsible for monitoring provider performance and reporting to SHCN management to track and share data with practice on performance against goals, escalating any issues at the practice level in a timely manner.
• Report on quality measures and evaluate strengths and weaknesses and address workflow deficiencies.
• Works collaboratively with assigned Performance staff, Office Managers, and practice staff to coordinate improvement efforts related to overall performance.
• Implements performance improvement plans at the practice level.

• Produces and maintains record by keeping documentation up to date and reporting progress on a weekly basis.
• Provides dashboard reports to providers and practices and recommendations on improvement.

• Educates providers and leadership on clinical indicators to capture the severity of illness of the patient.
• Develops and delivers training materials (Provider and Practice-Facing).
• Provides leadership and staff with training, on-site collaboration and on-going performance reporting.

Education / Experience / Other Requirements

• Medical Assistant of LPN license preferred, or equivalent clinical experience

Work Related Experience:
• 2-3 years of physician practice experience preferred

Specialized Knowledge:
• Knowledge of quality metrics and risk adjustment preferred

Application Instructions

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