The MassHealth Performance Facilitator will work with physician groups, practices, and providers in improving their performance in MassHealth quality measures/outcomes and total medical expense management. This position will be an essential point of contact for practice staff and is responsible for communication of targets for medical expense trend and quality outcomes, as well as the facilitation of activities to meet identified targets in quality, cost, and utilization.
Serves as a central resource and liaison to network stakeholders for MassHealth activities. Proactively communicates and collaborates with BIDCO physician groups and office staff to aid in successful management of total medical expense .
Serves as a central resource to PCP practices on implementation of MassHealth-related quality improvement initiatives. Provides support for population management at the pod and practice level by tracking and monitoring individual process and outcome measures for MassHealth ACO patients who have chronic diseases such as diabetes, cardiovascular disease, and depression.
Acts as key resource to PCP practices for the management of registries of MassHealth patients who have chronic diseases to ensure that they receive the required testing and medical management to promote optimal health and clinical outcomes.
Aids in monthly review and dissemination of key analytic reports to track overall pod and provider performance. Presents complex data clearly in a variety of formats and effectively communicates key findings to drive informed decision making.
Organizes, maintains and updates patient data bases, program rosters, and any other lists and resources for the department as required.
Required Qualifications:Associate's degree required. Bachelor's degree preferred.
1-3 years related work experience required.
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Competencies:Decision Making: Ability to make decisions that are based on specific instructions, standard practices and established procedures which generally require little or no supervision.
Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.
Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.
Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
Age based Competencies:
Employees in this job must be competent to provide patient care to the following age groups: Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally