- Medical Office Experience
Allegheny Health Network
Job Description :GENERAL OVERVIEW:
The Clinical Integration Manager works collaboratively with participating CIN practices, regional concierge team and CIN leadership to implement clinical integration initiatives by encouraging physicians and care teams to explore the benefits, challenges and opportunities in improving health care outcomes while containing healthcare costs. Develops and implements strategies to promote the principles of value based, patient centered care delivery and the goals of the CIN. Serving as a consultant, cultivates in-depth relationships with assigned practices and regional partners through in-person meetings to set strategic priorities, reports results and identifies opportunities for improvement.
The Clinical Integration Manager will provide training to assigned practices to utilize and understand CIN cost/utilization reports and use of analytics technology. Performs ongoing in-depth analyses practice performance reports and other data to identify opportunities, develop practice specific action plans and implements strategies to achieve CIN pay for value goals. (25%)
Within their assigned CIN region, the Clinical Integration Manager, through a consultative role, will provide training and foster adoption of optimized workflows, enhanced panel management techniques, improved HER technology utilization, and education on regional quality cost and utilization opportunities, all designed to improve patient access to high value care, prevent unnecessary episodes of high cost care and improve patient outcomes. (25%)
Works collaboratively with regional operations team and Local Advisory Council (LAC) leaders to develop POD specific goals and clinical integration strategies. Prepares LAC presentations and provides progress reports based on regional goals. If applicable within assigned region, actively participates in regional quality councils. (10%)
Assists with recruitment and practice onboarding; Performs practice capability assessments and develops comprehensive analysis of findings. (10%)
Facilitates introduction/implementation of AHN/CIN Primary Care transformation initiatives and PCMH principles. Serves as the liaison for care path implementation and care management programs (ECCM) by facilitating introduction and implementation of these services within the practices. (10%)
Participates in the development and delivery of regional practice manager educational programs, webinars, learning collaborative and dissemination of best practice workflows and strategies. (10%)
Actively participates and contributes in regional CIN operations meetings and corporate team meetings. (5%)
Other duties as assigned. (5%)
Bachelor's degree in Nursing or health related field
3-5 years Medical Office Operations experience
1-3 years population Health Health Management principles experience
PA Registered Nurse license
1-3 years pay for value programs/payer contracts experience
0-1 year experience with Patient Centered Medical Home principles
Compliance Requirement: As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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