Overview:
How have you impacted someone's life today? At Hackensack Meridian Health our teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career, all within New Jersey's premier healthcare system.
The ACO Transition Assistant works closely with ACO Care Coordinators, physicians and staff in coordinating and communicating gaps in quality care metrics for all ACO patients. They assist with low risk patient navigation and preventative screening compliance. The Transition Assistant works independently to audit clinical data and assist in educating ACO providers and staff. This promotes workflows that support quality patient care and compliance with documentation and clinical outcome metrics. The Transition Assistant will communicate with the healthcare team to assist patients in transitions of care across the healthcare continuum. Finally the Transition Assistant is accountable along with the care coordinator for training and continually updating ACO practice staff to meet clinical quality guidelines and facilitate high quality safe patient care.
Qualifications:
Education, Knowledge, Skills and Abilities Required:
- Associate's degree or relevant years in healthcare, medical insurance billing, auditing or related field.
- Excellent analytical skills.
- Good reasoning and problem solving ability.
- Highly developed interpersonal skills.
- Proficient at multi-tasking and prioritization.
- Ability to work independently as well as in a team environment.
- Highly organized.
- Good presentation skills.
- Demonstrated proficiency with PC and Microsoft office skills. Ability to learn and become proficient in ACO electronic medical records and ACO software applications.
Education, Knowledge, Skills and Abilities Preferred:
- Registry skills.
- Experience with auditing commercial medical insurance payers.
- Bilingual in Spanish.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!
Responsibilities:
A day in the life of a Transition Assistant, ACO at Hackensack Meridian Health includes:
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Audit clinical records for gaps in quality care metrics and create corrective plan with ACO practice to facilitate collections and reporting of required quality metrics.
- Train, educate and update ACO physicians and staff on payer program metrics.
- Assist in workflow design that promotes compliance to ACO standards and clinical quality metrics.
- Provide monthly reports to practice to assist with quality metric performance that will maximize shared savings opportunities.
- Work with providers, care coordinators and office staff to ensure safe patient transitions.
- Accountable for preventative care metric documentation.
- Contacts ACO patients to make appointments for outstanding provider follow ups, labs and diagnostics as directed by ACO providers.
- Performs both internal and external audits for Medicare, Aetna, Horizon, Qualcare payers. Communicates gaps in quality metrics to providers and ACO management on a monthly basis.
- Assist practice in scheduling appointments and referrals which improves accessibility of office services and patient satisfaction.
- Travel to assigned ACO offices to ensure compliance with ACO policies and procedures as directed by ACO management.
- Work with management and care coordinators to utilize ACO software to create and report on ACO outcome measures such as ER, inpatient and sub-acute usage.
- Audit medical records to ensure documentation conforms to CMS standards for inclusion and exclusionary clinical guidelines.
- Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
- Adheres to the standards identified in the Medical Center's Organizational Competencies.
