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Practice Transformation Specialist

2 months ago

Houston, Texas, United States Apex Health Solutions Full time
Job Description

Job Summary:

The Practice Transformation Specialist is a key member of the Apex Health Solutions team, responsible for driving value-based care initiatives and supporting the implementation of transformative healthcare processes. This role reports to the Manager, Practice Transformation, and is focused on providing on-site and remote assistance to clinicians, care teams, and their associated practices to improve clinical quality, risk adjustment, and operational efficiency.

Key Responsibilities:

  • Coaching and Guidance: Provide customized coaching to clinical practices, focusing on process improvement, value-based care, and team-based care. Develop skills in analyzing quality data and measurements to drive patient outcomes.
  • Practice Transformation: Partner with practices and health centers to ensure health plan goals are met, particularly in relation to HEDIS/STARs and Risk Adjustment. Develop strategic plans to assist with performance improvement at the practices/health center level.
  • Education and Training: Create or assist in the creation and facilitation of educational materials, presentations, and workshops for clinicians and staff. Develop and maintain communications, such as one-page educational documents, newsletters, and website content.
  • Analytics and Data: Utilize available tools to assist clinicians with capturing and analyzing population-based data to support data-driven decision making and direct improvement efforts.
  • Quality Improvement: Work with practice sites to produce reports on their progress on quality, financial, and utilization goals. Share outcomes of quality and clinical measures, and provide support for clinical documentation improvement activities.

Requirements:

  • Minimum five (5) years of experience with value-based care arrangements required.
  • Minimum five (5) years of experience with a focus on EMR operations, use, design, and implementation.
  • Minimum three (2) years Risk Adjustment experience required.
  • Minimum three (3) years of healthcare experience with an understanding of physician needs and practice workflow.
  • Minimum five (3) years of medical practice management, clinical program development, clinical transformation, healthcare quality analytics, and/or quality improvement.
  • Minimum five (3) years of experience in team management, coaching teams to drive transformative initiatives.
  • Minimum three (4) years of provider-facing experience required.
  • Knowledge of CMS STAR Ratings Program requirements required.
  • Knowledge of Risk Adjustment required.
  • Knowledge of HEDIS and NCQA requirements.
  • Strong communication and presentation skills required.
  • Interpersonal skills necessary in order to interact effectively and build strong relationships with physicians, staff, and all levels of management.
  • Proficiency in Microsoft Office Professional products, including Visio and PowerPoint.
  • Ability to analyze data and use data to drive change.

Education/License:

  • Bachelor's Degree in a related field or five (5) years of related experience.

A license in one of the following is preferred:

  • Certified Risk Adjustment Coder (CRC)
  • Certified Professional Coder (CPC)
  • Certified Professional in Healthcare Quality (CPHQ)
  • Licensed Vocational Nurse (LVN)
  • Registered Nurse (RN)