Quality & Value Clinical Specialist - LPN-PHSO

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

2600 LUCIEN WAY

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Utilizes data from multiple sources to identify patients with upcoming appointments and conducts thorough chart reviews to determine patient-specific opportunities around open orders, care gaps, coding, medication management, and annual wellness visits. Outreaches patients to complete health risk assessments, follows up on open orders, reviews medications, assesses social determinants of health, schedules/reschedules appointments as needed, and attempts to obtain any outside records for care gap closure and continuity. Contacts patients and families to evaluate their status following discharge from an emergency department or hospital, ensures transitional care management follow-up care is highly coordinated within appropriate time frames, obtains discharge records, calculates LACE scores, reconciles medications, and reviews symptoms. Documents in the upcoming patient encounter all necessary information relevant to the appointment, including suspect conditions, screenings, specific care gaps to be addressed at the visit, initiates orders as needed, updates health maintenance topics, and provides any other key information obtained in the pre-visit planning stage. Answers patient questions within scope and relays other questions and pertinent information by taking accurate messages and routing to appropriate clinical staff. Abstracts records and follows the appropriate process to notify the health plan of documentation for HEDIS care gap closure and other specific program measures. Addresses barriers to care and assists as needed to connect patients and practices to additional internal and external resources, including pharmacy, care management, health plan, and other available programs. Understands strategy to meet program objectives, helps identify performance improvement opportunities, and ensures practices are equipped with pertinent information and tactics to meet goals. Maintains knowledge of practice workflows and coordinates with clinical trainers on best practices. Participates in meetings with payers, practices, and cross-functional teams. Manages and monitors staff productivity levels, quality of output, and resolves workplace-related issues to promote continuous performance improvement. Provides training to team members and oversees efficient departmental operations. Performs other duties as assigned.Knowledge, Skills, and Abilities:
• Knowledge and understanding of chronic and acute disease conditions [Required]
• Proficient in Microsoft Office, PowerPoint, Word, and Excel [Required]
• Excellent communication skills, both verbal and written [Required]
• Knowledge and understanding of value-based care concepts [Required]
• Proficient at learning and working in multiple computer systems [Required]
• Skilled at preparing records and responding to correspondence [Required]
• Flexibility in prioritization and highly organized [Required]
• Ability to build relationships and collaborate with multidisciplinary teams [Required]
• Self-motivated with strong critical thinking abilities [Required]
• Knowledge and understanding of CDI, RAF and HCC coding [Preferred]
• Knowledge and understanding of HEDIS and CMS Star rating measures [Preferred]

Education:
• Technical/Vocational School [Required]

Field of Study:
• Graduate of a nursing or medical assisting program
• Advanced degree in healthcare and/or medical billing coding

Work Experience:
• 3+ years of healthcare experience [Required]
• Epic or other EMR experience [Required]
• Primary care office experience [Preferred]
• Quality programs experience [Preferred]

Additional Information:
• N/A

Licenses and Certifications:
• Certified Professional Coder (CPC) [Preferred]
• Certified Coding Specialist (CCS) [Preferred]
• Certified Outpatient Coder (COC) [Preferred]
• Licensed Practical Nurse (LPN) [Required] OR
• Certified Medical Assistant (CMA) [Required]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$19.22 - $35.75

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.