POPULATION HEALTH OPERATIONS SPECIALIST

JOB OVERVIEW
The Population Health Operations Specialist is responsible for supporting value-based care delivery for the organization and providers by playing a central role in achieving quality improvement outcomes across numerous payor programs. The Population Health Operations Specialist role is a hands-on position leading their assigned practices in improving Key Performance Indicators (KPIs) outlined in s Value Based Payment (VBP) agreements. These KPIs include clinical quality measures, membership engagement, facility utilization, and costs measures. 

JOB REQUIREMENTS

High School Diploma or GED Required
Bachelor's Degree Preferred
 

Work Experience

2 - 3 years relevant experience Required
    Experience with quality improvement process Preferred

Highly organized with excellent oral and written communication skills • Able to manage multiple tasks and projects simultaneously 
Excellent interpersonal, troubleshooting, and decision-making skills • Comfortable with continuous changes and self-initiating 
Proficiency with Microsoft Office Suite (e.g., Excel, Word, Outlook) • Experience with electronic health records. • Ability to maintain a non-judgmental disposition and communicate with a diverse population. 
Understanding of medical billing and coding in a practice setting • Basic knowledge of payor claims processes 
 

Job Responsibilities
Essential Function
Practice Development and Quality Improvement 
Helps practices adopt, transform, and sustain value-based model of care
Educates and trains teams on quality measures specifications, including knowledge of appropriate billing codes and/or documentation needed by the payor to meet the measure. 
Participates in the design, implementation and monitoring of quality improvement processes, including continuous assessment of challenges in achieving stated goals.
Maintains a reporting system to measure success and areas for improvement during the implementation and maintenance phases of transformation. Assists in creating performance dashboards and facilitating the request of custom reports to ensure the success of partners
 

Other Job-Related Information:

Working Conditions:

Climbing - Rarely

Hearing: Conversation - Consistently

Hearing: Other Sounds - Frequently

Kneeling - Rarely

Lifting 50+ Lbs. - Rarely

Lifting <50 Lbs. - Occasionally

Pulling - Rarely

Pushing - Rarely

Reaching - Rarely

Sitting - Frequently

Standing - Rarely

Stooping - Rarely

Talking - Consistently

Use of Hands - Frequently

Color Vision - Occasionally

Visual Acuity: Far - Frequently

Visual Acuity: Near - Consistently

Walking - Frequently

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: 

Serve: ALWAYS…

• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"

• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist

• Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS…

• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met

• Offer patients and guests priority when waiting (lines, elevators)

• Work on improving quality, safety, and service 

Respect: ALWAYS…

• Respect cultural and spiritual differences and honor individual preferences.

• Respect everyone’s opinion and contribution, regardless of title/role.

• Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS…

• Value the time of others by striving to be on time, prepared and actively participating.

• Pick up trash, ensuring the physical environment is clean and safe.

• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS…

• Acknowledge wins and frequently thank team members and others for contributions.

• Show courtesy and compassion with customers, team members and the community