Quality Performance Consultant Lvl 2

The Quality Performance Consultant (QPC) aids in advancing quality performance across Cone Health Medical Group, THN-affiliated practices, and independent primary care practices involved in value-based contracts. QPCs track performance levels within contracts and quality metrics at both the network and practice levels. Using performance data analysis, they pinpoint areas for improvement and serve as experts in HEDIS and other quality measures stipulated in contracts. The primary focus of this role is to educate healthcare providers and practice teams, streamline workflows, enhance documentation practices, and facilitate quality-oriented patient care. Through regular engagement with primary care practices, QPCs implement a structured, quality-focused agenda and provide ongoing support to enhance quality outcomes, patient satisfaction, and cost-effectiveness.

Essential Job Function

• Acts as the primary partner for quality performance in assigned practices, responsible for managing relationships and maintaining continuity.
• Facilitates touchpoints, tracking, and elevations for allocated clinics in collaboration with QPS and practice leaders.
• Serves as an intermediary between the IT support team focusing on EMR quality functionalities and quality tools such as Innote and Innovacer, and the healthcare facilities.
• Track the comprehensive performance of contracts and gauge the effectiveness of performance within network and practice environments. Employ performance statistics and dashboard displays to highlight potential areas for improvement, risks, and patterns.
• Facilitate the onboarding process for a recently established clinic and its healthcare providers with two days of comprehensive support and in-person coaching. Offer insights into the quality criteria set forth in contractual agreements and elucidate the process of evaluating performance outcomes.
• Act as a specialist on HEDIS and other agreed-upon standards; respond to queries from providers and their teams.
• Creating a comprehensive documentation framework and workflow sequences is crucial to measure success effectively across different domains. It involves establishing standardized procedures for recording and tracking data related to preventive care, pharmacy services, patient experiences, and healthcare utilization. Employing a consistent approach to documentation helps maintain accuracy and consistency in the measurement process
• Ensure regular presence at every primary care practice each month, prioritizing a quality-centered schedule. Make supplementary visits as required to support the practices effectively
• Display the lists of gaps in members' coverage as reported on the Practice Dashboard.
• Aid in organizing tasks based on their significance, outlining steps for execution, and overseeing the advancement to foster measurable enhancements. Help in the utilization of Innovaccer dashboards for assessing efficiency and forming registers of patients. Work together with healthcare settings to pinpoint chances for growth, establish tailored objectives for boosting quality, and develop procedures for improving healthcare services and regulating expenditures.
• Deliver education and optimization aid for Epic EMR and additional EMR quality workflows focusing on documentation standards, OPAs, health maintenance, and reporting/registries. Provide guidance for clinics using different EMR platforms to ensure they meet the required levels of quality documentation.
• Offer assistance for implementing InNote and comparable tools efficiently. Help independent practitioners in effectively integrating Innote into their workflow and address any inquiries they may have. Develop a comprehensive database for storing quick facts related to One Note, ensuring that it is easily accessible to independent practices
• Enable and endorse the execution of the Pathway to Performance Improvement (PPI) Program for affiliated practices within THN.
• Produce and uphold concise reference guides, instructional tools, and workflow assistance documents. Utilize established one-pagers and training content; escalate any challenges to the appropriate authorities as needed.

Education

• Required: Bachelor s degree in a related field, or an additional 4 years of equivalent education and/or professional experience in lieu of a degree.

Experience

• Required: Minimum of 3 years of experience in ambulatory operations, quality/performance improvement, or provider-facing consulting/education.

Licensure/Certification/Listing