Population Health Specialist- Payer Quality Incentive Programs Remote

Duke Connected Care, a community-based, physician-led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas.

 

The Payer Quality Population Health Specialist role works in coordina tion with the PHMO leadership as well as contracted payers. This positio n works closely with Duke’s contracted payers to ensure all contractual obligations are accomplished successfully and within the proper timefram e. This position will work closely with the Team Lead as well as helping coordinate projects with the Payer Quality team at PHMO. They are respo nsible for making sure all projects and payer specific tasks are completed by the end of certain timelines. The PQ PHS will collaborate with man agement, payers, and Payer Quality team members to identify, plan and ex ecute projects throughout the year and to ensure compliance according to policies and procedures.

 

Dut ies and Responsibilities of this Position:

·         Provides regular oversight and coor dination of payer activities and projects and works closely with Team Lead to execute payer work in a timely manner

·          Participates/co-leadsclinic-based projects with Duke Health Leadership

·         Works with teams to ensure payer assignments are completed within appropriate timelines as well as managing gap closure efforts fo r each assigned payer

·         Represents program interests and goals at internal and external m eetings

·         Assists with training for new hires and updating training documents

·         Maintains timely communica tion with Team Lead/Leadership focusedon payer expectations and delegat ed assignments

·         Effectively communicates via multiple methods to include email, telephon e, virtual, and jabber about payer and clinic-based projects

·         Prepares, organizes, track s and reports outcomes of data on all project-based work

< span>·         Assists with identifying workf low improvements on project-based work

·          Reviews patient charts to identify and confirm e xisting and open conditions identified by payers

·         Completion of patient outreach to addr ess care gaps (occasional)

·         </ span>Other duties as needed

Minimum Qualifications

Education

Bachelor's degree in business, behavioral/social sciences, public health or related population health field.

Experience

Work requires three years of experience in a business, behavioral/ social sciences, public health or related population health field. Sales and Marketing background, along withprofessional experience in Social Work, Disease Management, and experience working directly with Physicians and Advanced Practice Providers is strongly preferred.

Degrees, Licensures, Certifications

N/A

 

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

 

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

 

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.