Medical Practice Consultant
Job ID 2013-21588 # Positions 1
Location US-NV-Las Vegas
Search Category Health Care Operations
Type Regular Full-Time (30+ hours) Posted Date 1/4/2013
Additional Locations ..
More information about this job:
The Medical Practice Consultant will be responsible for working with Primary Care Providers (PCPs) to facilitate the transition and redesign of the delivery of care into Patient Centered Medical Homes (PCMH). The MPC will be the primary liaison, coach, and facilitator working with PCP practices in the PCMH collaboration. The MPC will work with the medical director, along with associated health plan and corporate personnel to support and promote Amerigroup’s medical home initiative and strategy.
1. Performs practice assessments to provide a baseline understanding and a gap analysis from which to develop the action plan for practice transformation.
2. In conjunction with the practice, develops a Practice Transformation Plan (PTP) with goals, timelines, and redesign team ownership.
3. Provides onsite change management and quality improvement coaching to PCPs in their practice transformation.
4. Analyzes, summarizes, and shares provider collaboration reports, identifying gaps and opportunities for improvement. Understands performance reporting and measurement and has the ability to explain data reports. In addition, assures that participating practices submit their measures/metrics and monthly/quarterly reports.
5. Works with health plan leadership to identify and assess provider groups for engagement in the PCMH initiative.
6. Educates participating providers & staff on the PCMH initiative and enhanced reimbursement strategies, external recognition/accreditation programs and HITECH meaningful use criteria and coaches practice to achieve them.
7. Tracks and responds to in-person, telephonic, and written inquiries from providers and document all contacts in appropriate system per Plan (i.e. Sales force).
8. Takes an active role in ongoing program development and evaluation.
9. Performs other duties as assigned.
EDUCATION AND EXPERIENCE
- Bachelor’s degree in Business Administration & Management, Healthcare Administration and Management or related field.
- Coursework focusing on organizational behavior, leadership, change management, quality improvement, or health care.
Years and Type of Experience Required:
- Minimum 5 years of combined experience in health care, project management, quality management, professional training/teaching, or provider practice management.
Experience with one or more of the following:
- Process Improvement experience or Lean Six Sigma.
- Project management Practice Management.
- Quality Management/HEDIS measurements.
- Clinical Experience (RN, PA, or NP).
- Health care medical economics principles and concepts.
Specific Technical Skills
- Ability to cultivate and maintain positive internal and external relationships.
- Excellent interpersonal skills.
- Excellent social skills.
- Thorough appreciation of cultural diversity and sensitivity toward target populations.
- Ability to work independently.
- Organization, planning, setting goals and objectives, time management.
- Ability to move toward multiple long-term goals, including coordinated internal and external improvement efforts, while meeting short-term objectives.
- Ability to analyze, interpret, and support recommendations with statistical data o Demonstrated understanding of relevant quality improvement tools.
- Ability to effectively communicate statistical and qualitative interpretations in a non-offensive manner to medical professionals and staff.
- Ability to guide the provider to better performance.
- Ability to demonstrate relevant quality improvement and project management tools to PCP staff, and to get sustainable commitment from staff to use them effectively.
- Understanding of adult learning and organizational behavior, particularly leadership and organizational change.
- Experienced in developing (professional-level) presentations.
- Excellent verbal and (professional-level) written communications skills.
- Ability to learn from PCP staff, as well as teach them.
- Ability to lead internal and external process improvement efforts.
Certifications or Licensures
- Certification that documents understanding of relevant project management and quality improvement tools.
- Lean Six Sigma (Green Belt or above).
- Clinical License (LPN, RN, NP, PA, or LCSW).
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.
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