If you are an energetic individual who enjoys being part of a collaborative and talented team then a rewarding career with Northeast Georgia Health System is where you want to be!
The ACO (Accountable Care Organization)Population Health Quality Nurse RN assists with the implementation and collection of clinical quality data for the ACO Medicare Shared Savings Program (MSSP) quality metrics and other value based quality metrics stipulated in the Payers contracts. Effectively works with Physicians and care coordinators to implement the quality improvement program of the ACO. This position deploys population health management tools to participating office and care coordination staff, conducts education and training sessions with physician practices to ensure value-based program and ACO readiness. Shall produce and distribute reports to the ACO participants. Responsible to facilitate the successful achievement of ACO quality initiatives as the dyad between the ACO participant groups and ACO leadership.
Minimum Job Qualifications
Licensure or other certifications:
Current active GA RN license required; RHIT with training in coding desirable.
Bachelor's Degree in health care administration, business or related field preferred.
Five years of experience in health care operations with a focus in population health required and working in an ACO strongly preferred. Two years of experience implementing the Healthcare Effectiveness Data and Information Set (HEDIS) measures across a multidisciplinary team is desirable. Patient Centered Medical Home experience or understanding is required. Advanced skills in abstracting and reporting of data required.
Job Specific and Unique Knowledge, Skills and Abilities
1. Proven ability to develop work standards, policies, processes, and procedures that impact multiple groups.
2. Effective and superior verbal and written communication skills, facilitation skills, and presentation skills required.
3. Demonstrated critical thinking, influencing, problem solving, and analytical skills required.
4. Excellent interdependent leadership and strategic thinking skills, and the ability to drive business results by motivating staff.
5. Knowledge of the contemporary issues in the areas of quality, risk reduction, and customer service with demonstrated results addressing these issues.
6. Decisiveness, action-orientation, personal integrity, capability to persevere in difficult situations and a focus on strategic leadership issues required. Incumbent should also possess an open, collaborative leadership style that promotes teamwork and partnership while achieving desired results. Demonstrated ability to lead professionals through influence and collaboration.
7. Proficient in team building, conflict resolution, group interaction and results orientated. Demonstrated knowledge of population health and value-based payment arrangements.
8. Excellent skills in complex analytic problem solving, project management, lean thinking, change management, and group process.
Essential Tasks and Responsibilities
1. Serves as a liaison with the ACO participants and manages the communication between CMS and the ACO to ensure all tasks and timelines are met, in dyad with the Director of Quality and the Medical Director.
2. Develops tools to educate Physicians and staff on the ACO quality measures, how to meet them and how to achieve optimal results with the ACO metrics.
3. Ensures on-going readiness to report ACO-submitted metrics completely, accurately and on-time. Establishes an ACO metric reporting process for each ACO participant.
4. Plans and organizes annual CMS and or other payer reporting requirements with ACO participants and or HP2 providers.
5. In concert with the Quality Director, develops a patient feedback tool aligned with the CAHPS ACO survey tool to poll patient experience and patient satisfaction to pinpoint areas for improvement and identify best practices.
6. Educates ACO participants on the CAHPS for ACO survey and coach them on how to positively impact the survey results with their patients throughout the year.
7. Uses various CMS reports to track the progress of the ACO MSSP in meeting its goals and is responsible to ensure ACO participants are in compliance with MSSP rules and regulations.
8. Identify target areas for education and outreach to improve reporting accuracy. Improve adherence to reporting requirements. Provides actionable data which will highlight areas needing improvement and identifying best practices that could be shared.
9. Responsible to ensure the ACO website is kept up-to-date based on MSSP requirements.
10. Organizes and deploys on-going ACO metric audits to ensure each ACO participant is capturing the necessary components of each ACO measure; identifies and deploys corrective action plans as deemed necessary in dyad with the Quality Director.
11. Monitors the progress of each ACO measure with each ACO participant throughout the reporting year to promote ongoing compliance.
12. Participates in the Clinical, Operational and Integration (COI) workgroup and task force meetings preparing agendas and materials and circulating information in advance as deemed necessary. Maintains records of all meetings, discussion and decisions, for future reference in an orderly secure manner.
13. Administers and coordinates projects that lead to better care and lower costs for ACO patients. Work with the HP2 team to enhance physician engagement, beneficiary engagement, care coordination and the ACO Administrative Team (IT, financial, analytical and compliance) to improve patient health outcomes.
14. Annually, or more often as deemed necessary, updates the Quality Work plan to reflect the most recent ACO metrics and other value based payer metrics.
15. Fully understands the chart documentation necessary to satisfy each ACO and value-based payor measure and interprets the data guidance and metric specifications to achieve results.
16. Works with the appropriate staff to design and develop marketing materials that will enhance communication within the ACO and patients.
17. Leads conference calls and meetings as assigned with the ACO participants, physicians and their staff to ensure goals are understood and are met.
18. Participates in conferences regarding value-based payment arrangements with HP2 leadership and payers to foster open, effective communication and the achievement of mutual expectations.
19. Facilitates an atmosphere of mutual understanding and trust that promotes sharing of best practices.
More Awards and Accolades.
Ranked in the Top 10% in the nation by CareChex® for Stroke Care, Cancer Care, Pneumonia Care and Surgical Care, the System is the recipient of numerous accolades including:
- Georgia's #1 Surgery Hospital by CareChex®
- Georgia's #1 Heart Hospital by CareChex® - 12 years in a row
- Georgia's #1 Women's Hospital by CareChex®
- Georgia's #1 Pulmonary Hospital
- One of Metro Atlanta's Top Workplaces for the 7th year in a row
The Blue Ridge Mountains are less than a 30-minute drive and Lake Sidney Lanier is next door. Whatever setting suits your mood, you'll find it right here.
- 47 public parks
- 8 championship golf courses
- 34 tennis courts
- 10 marinas
Atlanta, with its abundance of sports including the Atlanta Braves, Hawks, Falcons, and Georgia Swarm, as well as entertainment attractions, is less than an hour to the south.
We value diversity and always hire equally and equitably.