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Healthcare Practice Consultant
2 months ago
At Memorial Hermann, we are dedicated to achieving a unified objective of providing exceptional, efficient healthcare while fostering outstanding experiences for every individual in our community. This commitment extends to our employees, as we believe that when they feel valued and supported, they are motivated to create moments that surpass expectations, emphasizing safety, compassion, personalization, and efficiency.
Position Overview
This role is pivotal in establishing and nurturing ongoing relationships with physicians and their office teams within the Memorial Hermann Physician Network (MHMD). The individual will collaborate with MHMD physicians to meet the targets outlined in established incentive programs and to secure recognition from national accrediting organizations, insurance providers, or other relevant entities for achievements in disease management, population health, medical cost management, and the adoption of Patient-Centered Medical Home (PCMH) principles. This will involve overseeing application processes, monitoring compliance with established benchmarks, and recommending process improvements to enhance performance. Key Responsibilities
Minimum Qualifications
Education: Bachelor's degree in a relevant field or four (4) years of related experience.
Licenses/Certifications:
Preferred licenses include:
National Committee for Quality Assurance (NCQA)
Certified Professional in Healthcare Quality (CPHQ)
Certified Medical Office Management (CMOM)
Experience / Knowledge / Skills:
- Minimum of three (3) years of experience in healthcare with a solid understanding of physician requirements, practice patterns, and operational workflows.
- Exceptional communication and presentation abilities.
- Strong interpersonal skills for effective interaction and relationship building with physicians, staff, and management.
- Outstanding organizational and prioritization capabilities; adept at managing multiple projects simultaneously to achieve desired outcomes.
- Analytical skills to identify client needs and formulate actionable plans.
- Proficient in Microsoft Office Suite, including Excel, Word, and PowerPoint.
- Familiarity with major quality improvement initiatives (PQRI, NCQA, CI, HEDIS, etc.).
- Ability to travel to physician meetings and offices within the regional area.
- Act as the primary liaison between MHMD and its physicians and office staff regarding the implementation and utilization of Memorial Hermann resources aimed at advancing PCMH and ACO initiatives.
- Responsible for the deployment of programs at the practice level, including the introduction and education of practices on the value and application of reporting tools, patient registries, and report delivery through our physician portal to enhance patient care.
- Facilitate regular improvement meetings to monitor, present, and discuss progress on action plans and milestones.
- Maintain the necessary skills to analyze data and processes to identify and address undesirable patterns or trends in utilization or performance, obtaining resources to develop strategies for improvement.
- Collaborate with regional medical directors and management to identify and address organizational challenges that impede the achievement of program goals.
- Document action plans and details of visits and outcomes, reporting critical incidents and quality of care issues.
- Assist in resolving managed care reimbursement issues identified by providers or payers, including root cause analysis of fee schedules and contract reimbursements.
- Travel throughout the regional area to meet with physicians and office staff; attend office meetings and conduct presentations.
- Ensure compliance of documentation with state regulations and accrediting body requirements.
- Promote safe care for patients, staff, and visitors; adhere to all policies, procedures, and standards within budgetary constraints, including time and supply management.
- Encourage personal professional growth by meeting continuing education and skills competency requirements; support departmental goals that contribute to organizational success; serve as a mentor and resource for less experienced staff.
- Demonstrate a commitment to caring for every member of our community by creating compassionate and personalized experiences, embodying Memorial Hermann's service standards by providing safe, caring, personalized, and efficient experiences to patients and colleagues.
- Perform other duties as assigned.