Clinical Performance Representative (CPR)
LOCATION: Dignity Health
DEPARTMENT: Arizona Care Network (ACN)
SHIFT: 8HOUR, Day
EMPLOYMENT TYPE: Full Time
HRS PER PAY PERIOD: 80
JOB ID: 1700016962
Arizona Care Network (ACN) is a clinically integrated (CI) physician network and Accountable Care Organization (ACO) sponsored by Dignity Health and Abrazo Health, a Tenet company. The Clinical Performance Representative (CPR) is an employee of MedProVidex, a wholly-owned subsidiary of Dignity Health.
A Clinical Performance Representative (CPR) is a valuable resource for the clinical teams within the Arizona Care Network (ACN). ACN CPRs report to the Sr. Director of Practice Transformation within the Clinical Performance Department, and are responsible for educating our clinicians and their supporting teams in the ambulatory space on the value based arrangements (VBAs) our network supports, and also advise these teams on techniques to improve their performance on these VBAs. CPRs must have a strong understanding of care delivery in the ambulatory setting (specifically primary care), the current demands on primary care physicians and their staff, and also an ability to interpret clinical data and performance metrics commonly tied to performance in value based contracts (CMS ACO, HEDIS, NCQA, etc) and Medicare Advantage programs (HCC/RAF). In addition these positions also support our clinicians and their teams on ways to improve the patient experience. Excellent communication skills are critical for the CPRs they are the primary vehicle for the delivery and discussion around clinical performance with supported clinicians and their operational leads.
- Interpretation of clinical score cards for multiple VBAs.
- Aggregation of clinical data into dashboards and other vehicles for distribution to practices and physician groups.
- Generation of educational materials which support our clinicians and their teams on understanding clinical quality measures (tip sheets, tool kits, presentations, etc).
- In partnership with the Sr. Director of Practice Transformation, development of quality improvement programs to meet the needs of their supported medical practices.
- Implementation of quality improvement programs in close partnership with local leadership and other ACN stakeholders.
- Understanding of coding and billing workflows to improve performance on VBA quality measures, and importance of accurate HCC recapture and RAF scoring.
- Assistance in the QA process for ACN’s analytics and BI team.
- Assistance in the GPRO education and submission process.
- Leading of practice meetings (if requested) to review performance and implement quality improvement initiatives.
- Assistance in the rollout of ACN sponsored clinical IT platforms within ACN ambulatory practices (online registries, ACO portals, online referral platforms, etc).
- Close collaboration with ACN Embedded Care Team staff to assist them in direct patient assistance and consultation.
- Other duties as assigned
A) EXPERIENCE: Minimum 5 or more years working in a medical office, clinic, hospital or other relevant healthcare setting with 3 or more years clinical nursing experience. A combination of both may be considered. Clinical certificate or license (e.g., medical assistant, LPN, RT, RN, or similar). Must have excellent verbal and written communication skills; a solid knowledge of budgeting and financial practices. Must be able to communicate and interface effectively with internal and external customers. Able to summarize data findings concisely for internal and external stakeholders; able to make inferences and offer suggestions for workflow improvements and/or methods of data capture to improve performance in quality metrics. Proficiency with the Microsoft Office suite of applications.
B) EDUCATION AND TRAINING: Bachelor’s degree in health administration, public health, or related field preferred.
C) SPECIALIZED KNOWLEDGE AND SKILLS: Position requires a high degree of professionalism and competent judgment. Must possess a high degree of propriety in dealing with confidential situations, documents and information on a daily basis. Serves as mentor to teammates. Strong customer service skills with willingness to take initiative with litte to no direction. Demonstrated ability to analyze problems and issues from a variety of perspectives and to understand legal, privacy, risk, and operational impact of decisions. Knowledge of HIPAA, Title 22, security principles, guidelines, and standard healthcare practices in Arizona. Knowledge of information privacy and release of information laws. Detail-oriented and analytical skills required. Proficient in Windows operating system environment, information technology network infrastructures, access directory and Microsoft Office products. Excellent communication and interpersonal skills, both verbal and written. A demonstrated commitment to high professional ethical standards and a passion for organizational compliance. Knowledgeable of Accountable Care Organization requirements and structures. Ability and willingness to look at situations from several points of view. High comfort level working in a diverse environment. Healthcare experience preferred. Zendesk or other support ticket system experience a plus.
In business since 1993, Inland Health Organization of Southern California, Inc., now doing business as MedProVidex, is a wholly-owned subsidiary of Dignity Health. MedProVidex is a physician support organization that has historically provided physician practice and IPA management, but has expanded to support the infrastructure for Dignity Health’s Clinical Integration networks. In this capacity, MedProVidex provides local and corporate support resources to the Southern California Integrated Care Network (SCICN), the St. Rose Quality Care Network (SRQCN), Arizona Care Network (ACN), Sequoia Quality Care Network (SQCN), North State Quality Care Network (NSQCN), and future networks. MedProVidex is licensed to do business in California, Arizona and Nevada.
Dignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.
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