JOB SUMMARY : Assist the Quality Performance Measurement Unit staff with day-to-day operations to ensure optimum operations. PRIMARY RESPONSIBILITIES Transition of Care pools & Managed Care Programs Monitor network TOC pool for ED & MHL referrals and work with practices to schedule appointments as needed. Review patient charts along with Lab, Zwanger, and Cologuard portals to assess HEDIS measure compliance after receiving gaps in care (GIC) reports from the CIN for managed care incentive programs.
Check IDX if unable to locate patient. Work with practice administrators to close gaps by providing patient outreach opportunities. Follow up with practice administrators and provide detailed feedback to the CIN.
Review new patient rosters and notify practices of new patients and patients due for a well care visit. Respond to all emails. Answer calls to the SBCM concierge line.
Attend Meetings as necessary OTHER DUTIES AS NEEDED: Assist with running reports and pulling data and for ACO measures through Cerner and HealtheRegistries. Run reports for Promoting Interoperability measures and communicate any outstanding issues with the Practice Administrators for improvement Review daily UHMC email containing list of SBCM patients seen in the SBUH ED the previous day. Distribute patient information to the appropriate practices.
Report rapid flu test results to the HCS for all participating practices. Other duties as assigned