Network Engagement & Risk Coding Director - Northeast Georgia Health System, Inc

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Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

This role works with matrix partners across the organization to educate and manage provider performance expectations focused on quality measure outcomes, risk improvement and overall performance to financial targets in Health Partner’s value-based programs. Monitors and shares individual and group performance in regular face-to-face meetings using Key Performance Indicators (KPIs). Engages with providers and office staff to build trust and shift the way providers think about value-based care. Shall promote all clinical programs available as a resource to facilitate full engagement and improve outcomes. Shall play a critical role in fortifying the collaborative relationship we seek to establish with our physicians at the practice level.

• Licensure or other certifications:

• Educational Requirements: Bachelor's degree in Business, Healthcare, Information Science, or related field

• Minimum Experience: Minimum of 5+ years experience with increasing responsibilities in developing and executing risk coding programs.
  Knowledge of, and experience with, utilizing EPIC EHR.
  Knowledge of, and experience with, health plan value-based arrangements, alternative payment models, healthcare risk quality, and population health outcomes.

• Other:

• Preferred Licensure or other certifications:

• Preferred Educational Requirements: Master's degree in Business, Healthcare, Information Science, or related field preferred

• Preferred Experience:

• Other:

• Experience leading program development and management efforts involving provider/partner engagement and implementation.

• Experience developing and monitoring delivery of efficient and effective solutions to diverse and complex business problems.

• Demonstrated ability to embrace and utilize technology and other innovative solutions to deliver enhanced processes and results for provider partners.

• Expertise in creating training materials and delivering user training.

• Ability to establish strong relationships and maintain a high level of trust and confidence.

• Exceptional communication skills, internally and externally, with the ability to convey key messages and influence stakeholders and to convey technical concepts in easily understood ways.

• Strength in problem-solving based on experience, subject matter expertise, and objective data analysis.

• Comfortable working on simultaneous and diverse projects and activities.

• Self-directed, ability to execute projects with minimal supervision.

• Excellent time management skills with a proven abiltiy to meet deadlines.

• Ability to work under pressure with urgency and speed while maintaining a high degree of accuracy.

• Ability to communicate comfortably and effectively at all levels of organization to achieve results.

• Effective use of Microsoft Office software (Outlook, Excel, PowerPoint and Word).

• Shall develop a comprehensive risk coding accuracy program and curriculum in dyad with matrix partners to include leveraging effective efforts underway within the provider groups

• Leads collaborative efforts to design and create content-specific internal and external risk adjustment training curriculum and programs

• Shall set priorities for RA staff in a manner that executes on the right set of initiatives to improve risk scores

• Shall develop and or identify quality, risk score and financial KPIs that reflect each provider’s contribution towards goals for all contracted payer relationships

• Shall use dashboards and other reporting tools available from EPIC and or the payers to convey performance trends to providers, groups, and leadership

• Shall partner with providers and clinical/administrative staff to enhance understanding of clinical documentation improvement goals to achieve risk adjustment strategic goals and objectives

• Coordinate and deliver programs through flexible approaches including onsite, classroom, remote hosted, and self-service web-based models

• Design, execute, and report on evaluation methods and key performance indicators to measure results, identify risks/barriers to project rollout, timely deliverables, and adoption success

• Shall work in close partnership with Health Partners’ care management and quality teams to produce relevant material to share with the providers

• Shall participate in rolling out new programs and services to providers as they are developed

• Shall travel to Health Partner provider locations to oversee and execute engagement and shall document all visits in a standard format and retain for future reference

• Shall create organized presentations and other content to present to various committees and the Board

• Shall demonstrate the ability to be a strong people performance manager with the ability to motivate staff and drive results

• Ability to analyze project needs and determine resource requirements to meet objectives and solve problems that span multiple interdisciplinary teams and environments

• Shall build relationships and communicate with external and internal parties to deliver key messages, influence stakeholders, manage expectations, and shape outcomes

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Moderate, Frequently 31-65% of time

• Kneeling/Stooping/Bending: Occasionally 0-30% of time

• Standing/Walking: Occasionally 0-30% of time

• Pushing/Pulling: Occasionally 0-30% of time

• Intensity of Work: Occasionally 0-30% of time

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.