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Transition Assistant, Accountable Care
2 months ago
Overview
Our team members are the heart of what makes us better.
At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.
Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The ACO Transition Assistant works closely with ACO Care Coordinators, physicians and staff in coordinating and communicating gaps in quality care metrics for all ACO patients. They assist with low risk patient navigation and preventative screening compliance. The Transition Assistant works independently to audit clinical data and assist in educating ACO providers and staff. This promotes workflows that support quality patient care and compliance with documentation and clinical outcome metrics. The Transition Assistant will communicate with the healthcare team to assist patients in transitions of care across the healthcare continuum. Finally the Transition Assistant is accountable along with the care coordinator for training and continually updating ACO practice staff to meet clinical quality guidelines and facilitate high quality safe patient care.
Responsibilities
A day in the life of an ACO Transition Assistant at Hackensack Meridian Health includes:
- Audit clinical records for gaps in quality care metrics and create corrective plan with ACO practice to facilitate collections and reporting of required quality metrics.
- Train, educate and update ACO physicians and staff on payer program metrics.
- Assist in workflow design that promotes compliance to ACO standards and clinical quality metrics.
- Provide monthly reports to practice to assist with quality metric performance that will maximize shared savings opportunities.
- Work with providers, care coordinators and office staff to ensure safe patient transitions.
- Accountable for preventative care metric documentation.
- Contacts ACO patients to make appointments for outstanding provider follow ups, labs and diagnostics as directed by ACO providers.
- Performs both internal and external audits for Medicare, Aetna, Horizon, Qualcare payers. Communicates gaps in quality metrics to providers and ACO management on a monthly basis.
- Assist practice in scheduling appointments and referrals which improves accessibility of office services and patient satisfaction.
- Travel to assigned ACO offices to ensure compliance with ACO policies and procedures as directed by ACO management.
- Work with management and care coordinators to utilize ACO software to create and report on ACO outcome measures such as ER, inpatient and sub-acute usage.
- Audit medical records to ensure documentation conforms to CMS standards for inclusion and exclusionary clinical guidelines.
- Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
- Adheres to the standards identified in the Medical Center's Organizational Competencies.
Qualifications
Education, Knowledge, Skills and Abilities Required:
- Associate's degree or relevant years in healthcare, medical insurance billing, auditing or related field.
- Excellent analytical skills.
- Good reasoning and problem solving ability.
- Highly developed interpersonal skills.
- Proficient at multi-tasking and prioritization.
- Ability to work independently as well as in a team environment.
- Highly organized.
- Good presentation skills.
- Demonstrated proficiency with PC and Microsoft office skills.
- Ability to learn and become proficient in ACO electronic medical records and ACO software applications.
Education, Knowledge, Skills and Abilities Preferred:
- Registry skills.
- Experience with auditing commercial medical insurance payers.
- Bilingual in Spanish.
- Experience in a variety of patient settings
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today
Our Network
Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.
