Blue Cross And Blue Shield Association Philadelphia , PA 19107
Posted 1 week ago
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
Job Summary
Servicing a defined segment of multiple provider types (e.g. pediatric practices, family/internal medicine practices, specialist practices, etc.) with various levels of complexity in Pennsylvania and is a primary contact for assigned practices and/or health system partners.
The Population Health Specialist will collaborate and support the efforts of the Manager, Population Health, Medical Directors, and various interdisciplinary Independence teams to develop extensive practice relationships to drive continuous quality improvement. This effort will be directed at enhancing the efficiency, effectiveness, and experience of the Independence provider community in working with Independence Blue Cross.
The Population Health Specialist's responsibilities include, but are not limited to:
Plan, stage, and follow-up on provider visits
Manage meeting preparation, scheduling, and material content plus follow-up on presentations to multiple provider types
Understand and communicate detailed elements of Independence pay-for-performance programs to multiple provider types
Hold accountability for practice performance and proactively work with assigned practices to improve clinical performance
Independently develop schedule and targeting methodology for holistic quality improvement across assigned offices
Consistently partner with assigned practices to improve provider experience with Independence
Manage administrative elements of role in support of Population Health and interdisciplinary teams
Qualifications & Education
Experience, Knowledge, and Skills
Ability to travel in the Greater Philadelphia area required (driver's license and insured vehicle)
3-5 years' experience working in a primary care physician office or health system required
Demonstrated knowledge and experience with the CMS Medicare Stars Program required
Demonstrated experience with HEDIS and risk adjustment measures required
Knowledge of medical billing, claims processing systems, and health care information terminology preferred
Strong verbal and written communication skills including but not limited to effective group presentations to professional staff and management
Must be self-motivated, organized, and detail oriented
Must be able to work moderate complexity tasks independently
Must have strong knowledge of Microsoft Office products (Outlook, Word, Excel, and PowerPoint)
Must have strong analytical, influencing, and problem-solving skills
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app
Hybrid
Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
Blue Cross And Blue Shield Association