Value Based Network Specialist
Sanitas
Sanitas is a global healthcare organization expanding across United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness. Position Summary Develop, recommend and implement interventions at the practice level to improve risk, quality and utilization efficiency. Collaborate with regional leadership to facilitate redesign efforts, introduce population health management and support achievement towards improved financial, process and quality outcomes. Essential Job Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Serve as a liaison to practices to provide on-site and remote assistance and facilitation to the regional leadership team and their associated practices to drive improvement in risk coding accuracy, 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, 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. Review and interpret summary data and performance reports such as HEDIS, 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. Establishes and maintains positive and productive relationships with office staff and physicians at all assigned region Develops and maintains positive and productive relationships with all internal departments Identifies, tracks and resolves issues related to all operational and transactional relationships between assigned practices and Sanitas corporate, including network, risk, quality and care management Develops and maintains the preferred specialist network and manage the performance and expectation of the preferred network to meet all the unit cost, utilization and operational goals established in the referral program.Supervisory Responsibilities
This position has no supervisory responsibilities.
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