This is a multi-faced position with a range of dynamic projects and responsibilities. This position is responsible for achieving objectives and goals related to all programs, initiatives, and activities within the department and responsible for the implementation and evaluation of campus programs, projects, and initiatives and regional operations. This individual should be capable of effectively completing high-level management projects, applying analytical and problem-solving skills to support campus operations, as well as fulfilling coordination and admin duties. The incumbent is responsible for contributing and monitoring the regional re-admission trends, help identify areas that require member outreach and engagement, and associate with primary care physicians and specialists. They will monitor project progress and outcomes of special projects and provide oral and written presentations as requested to share special projects with other departments and external entities. This position provides general assistance and supports the Regional Medical Director, VP of Clinical Operations, Sr. Director of Administrative Operations, interfaces Executive team, and all employees, and will assist with special projects. This is a role with fast-paced, on the job learning and potential for upward-mobility with excellent performance.
Essential Duties and Responsibilities include the following:- Identifies opportunities for the development and implementation of approaches that improve efficiencies and produce high-quality care and optimal outcomes for the region.
- Works collaboratively with internal departments and staff to produce reports as requested.
- Supports the implementation of programs and interventions implemented within the region.
- Manage administrative review for 30/60/90 days hospital readmission data/trends.
- Engage with specialty providers and primary care physicians to review opportunities that can be utilized to better serve the campus member population.
- Support the campus with health plan audits but not limited to post stabilization, NOMNC, and routine audits.
- Oversee ongoing projects, which includes researching cases where providers are not listed on authorization, utilizing Verify/Comply compliance tools, generating reports, verifying the completion of tasks by responsible parties, and facilitating communication among team members.
- Distribute key metrics, news, and information related to the campus leakage trends, utilization, and post discharge activity.
- Monitors and analyzes programs and interventions to ensure fidelity and optimal outcomes within the region.
- Tracks and manages ongoing performance metrics and reports.
- Conducts ad hoc analyses to support regional operations.
- Works cooperatively and collaboratively with the executive team as well as Medical Directors.
- Coordinates and performs other duties, as assigned.
Education and/or Experience:- Masters degree preferred, but not required.
- Bachelors degree from four year university is preferred.
- At least 4 years prior full-time work experience (healthcare preferred).
- Ability to utilize advanced Microsoft Office Skills in projects, including Microsoft Excel graphing features, Microsoft Vizio flow charts, and Microsoft Word's Memo feature.
- Strong quantitative skill set, including working knowledge of statistics and intermediate to advanced mathematics skills.
- Ability to stay organized, meet company and departmental goals, and turn in timely and high-quality deliverables to region management.
- Extremely strong verbal and written skill set. Ability to write high-level communications to executives.
