Job Details
Location:
San Diego, San Diego County, California, USA
Posted:
Nov 07, 2019
Job Description
Position Purpose: Develop, recommend and implement interventions at the practice and membership level to improve clinical quality and operational efficiency. Collaborate with practices to facilitate redesign efforts, support care teams, introduce population health management and support achievement towards improved financial, process and clinical outcomes.
Serve as a liaison to practices to provide on-site and remote assistance and facilitation to the clinicians, care teams and their associated practices to drive improvement in clinical quality and operational efficiency.
Develop and execute set of intervention work plans to drive practice improve quality measures and transformation.
Develop and implement workflow design and redesign, including electronic health record (EHR) optimization, clinical documentation, billing practices, assessments, financial analyses, and financial performance improvement and reporting.
Develop and implement changes to root causes of financial and quality underperformance and communicate strategies to providers and provider groups.
Review and interpret summary data and performance reports such as pay for performance, HEDIS and medical cost ratio and develop data driven provider performance strategies.
Actively participate in cross-functional teams to conduct work and resolve enterprise and regional issues
About Centene
Centene is a multi-line health care enterprise offering Medicaid managed care and specialty services.
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