Care Coordination Specialist

at  RWJBarnabas Health

JOB OVERVIEW:

As part of RWJBarnabas Population Health team you will play an instrumental role in a department that is providing fully coordinated patient care from a holistic approach to improve the overall performance of the value-based population across the healthcare continuum by ensuring the population receives the right care, at the right time, by the right people. The Care Coordination Specialist is responsible for facilitating multiple components of care to include but not limited to gaps in care closure and preventive care, as well as playing a critical role in achieving Quality performance targets for value-based care. You will assist in providing cost-effective healthcare services throughout the care continuum. Most importantly, you serve as a liaison between patients, the care management team, physicians, payers, and all other participants of the health care team.

ESSENTIAL FUNCTIONS:

• Travel to assigned practices throughout NJ to meet with providers to perform EMR reviews, assist with data abstraction, provide education, support administrators and providers, and assist with scheduling and patient outreach as needed.
• Facilitate quality and utilization metrics data exchange between the practices and the Population Health data team to monitor quality metric gap closure.
• Liaise with practice management to share quality gaps reports and clinical opportunity reports e.g. member rosters, AWV gap reports etc.
• Assist in EMR chart reviews, data abstraction, tracking, and reporting on quality and utilization metrics for assigned programs and practices.
• Review charts to identify potential diagnosis codes and partner with the Practice Optimization Specialist to educate and inform physicians and other clinical care providers to address patient risk factors.
• Manage internal and external relationships to ensure that all needs are met.
• Handle a high workload and meet deadlines with a high level of accuracy and integrity.
• Perform clinical point of care testing and other clinical assessment procedures as directed to close quality gaps in line with departmental goals.
• Develop a close partnership with our Clinically Integrated Network Practices, Joint Venture Practices, and Rutgers Employed Practices and understanding the different types of EMR systems to successfully meet goals and metrics at a timely manner.
• Serve as a patient advocate and assist in identification and improvement of patient health outcomes.
• Display the highest standards of customer service and compassion.
• Navigate different insurance payors portals and understanding their patient roaster quality gaps guidelines so that goals are being met.
• Perform other duties as assigned.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.