The Clinical Relations Representative will be responsible to assist the organization to develop and maintain relationships with providers and their practices in order to successfully document and report quality metrics and meet the requirements of GPRO/PQRS specifically targeting high-cost chronic conditions, preventive care and patient safety. In addition, this individual will work closely with the practices to improve and implement correct diagnosis coding and documentation, and provide CAHPS education.
- Serve as clinical relations contact, in collaboration with the providers and their medical staffs for the following:
o to implement technical requirements such as correct use of CPT codes for certain diagnosis and treatments.
o for benchmarking data and goals.
o to supply information and analysis to assist in improving quality, expense and utilization.
- Provide on-site education and issue resolution from lessons learned from GPRO submissions.
- Collaborate with the clinical and care coordinator teams to develop and implement training and communications tools to assist the providers in delivering a high-quality, cost-effective patient careexperience.
- Serve as a resource for providers to answer questions, keep them informed about policies and procedures related to Shared Savings, including CAHPs and other patient satisfaction initiatives.
- Visit clinical practices to understand their goals, issues, operations, organization and identify how to integrate quality metrics / gaps in care into daily workflows.
- Prepare and distribute informational materials and communications necessary for the development of provider relationships with our organization and collaborative partners, provide informational updates and facilitate the practice transformation process.
- Participate in networking, Beacon University and other provider related events.
- Follow all applicable federal/state regulations with respect to Confidentiality, HIPAA, Code of Conduct and other compliance regulations and requirements.
- Interact in a professional, respectful and helpful manner
- Complete deliverables in a timely fashion
- Perform other duties as assigned
- Bachelor's degree in Business Administration, Health Care Administration or other related field required, Master's degreepreferred.
- Must have a clinical degree consistent with the assigned application and at least 5 years in a progressive clinical role or equivalent background with a strong understanding of the medical field.
- Demonstrates compassion, empathy, listening skills, organizational skills, people skills, problem-solving skills and time-management skills.
- Excellent written and oral communication skills
- Superior organizational skills, with a strong attention to detail and accuracy
- Intermediate knowledge of Microsoft Office Suite
- High level of professionalism and ability to work well with others
- Ability to prioritize and manage multiple projects and issues effectively
- Outstanding customer service skills
- Self-starter who can work with minimal supervision
- Ability to work both independently and in a team setting
- Capable of public speaking and delivering presentations
- Must be able to travel locally up to 75% of the time to physicians' offices.