Clinical Quality Associate

Full Time
Houston, TX 77004
Posted
Job description
Company Description


Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.


Job Description


*This position
is a hybrid role that requires in office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home.*

Overview of the Role:
Working closely with the Market-based Population Health teams, primary care providers (PCP’s), networked partners, and Operations Consultants at Privia Health, the Clinical Quality Associate will provide ownership and execution on defined Value-Based Care program performance metrics and support for Privia’s at-risk patients within a defined region. Primary work will include provider education, complete quality audits, patient outreach to provide coordination services, fill gaps in care, payer attestations, and regular review and action on local performance reports and regional action plans. The candidate will have relevant clinical experience, educational background or license/certification to support the Quality Management team.

Primary Job Duties:

  • Collaborate with local teams to define performance metrics
  • Own the execution and performance toward defined performance metrics
  • Review patient non-compliance reports and conduct telephonic outreach to ensure timely disease specific and wellness visits
  • Answer and resolve requests related to population health and quality measure specifications
  • Motivate patients to be proactive about their health
  • Provide education to providers and care center staff
  • Provide education and assistance with patient self-management goals
  • Make appropriate referrals to internal care team, payer programs, community resources, home care, and disease management programs
  • Assist in scheduling PCP or specialist appointments
  • Perform necessary payer attestation and performance reporting through payer portals
  • Operate independently to achieve agreed upon goals
  • Attendance and participation in performance meetings
  • Diligently maintain HIPAA and HR training, knowledge base and compliance at all times
  • Participate in special projects and perform other duties as assigned

Qualifications
  • 2 years of population health or patient engagement experience
  • MA, EMT, Health Coach, Case Management certification and/or experience preferred
  • Preferred experience with profession-based telephonic or remote communication.
  • Must comply with all HIPAA rules and regulations

Interpersonal Skills & Attributes:

  • Strong verbal communication skills, especially over the phone
  • Strong written and medical charting skills using proper grammar and terminology
  • Tech enabled from private and secured home office. Able to run multiple screens and applications simultaneously
  • Team focused: understands the need to work as a group to achieve goals, support team members, and listen to other points of view
  • Demonstrate sound judgment
  • Maintain a positive, caring attitude towards patients
  • Ability to function efficiently in a virtual environment and meet defined goals
  • Must be detail-oriented and possess critical thinking skills
  • Possess a focused work ethic and a high level of professionalism
  • Flexible, as work location is combination of corporate office and remote operations time
  • Self-motivated: Identifies opportunities and finds solutions to problems
  • Able to multitask effectively
  • Proficient with Microsoft Office applications including Word, Excel, and PowerPoint as well as Google Docs

Additional Information


All your information will be kept confidential according to EEO guidelines.

Technical Requirements (for remote workers):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.

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