Practice Integration Rep-PCCN

Position Details

Department: PCH-MAIN | Phx Children's Care Network
Category: PCCN
Location: Phoenix
Employee Type: Regular
Posting #: 478440
Posted On: 10/1/2019

Position Summary

Posting Note: This position will require travel throughout Maricopa County visiting primary care offices approxixmately 60% of the time. You will engage and effectively work with our providers to improve the quality experience for our patients by evaluating and improving quality measures. You must have a fundamental understanding of billing, HEDIS measures and quality assurance. This role will require someone who is self-directed, enjoys influencing and guiding other professionals as you drive quality improvements. If you have previous experience working in pediatrics, or you have been a hospital representative, please apply!

This position is responsible for developing and maintaining cooperative working relationships with providers in the Phoenix Children’s enterprise, Phoenix Children’s Medical Group (PCMG) and the Phoenix Children’s Care Network (PCCN). In addition, this position is responsible for ensuring that all, contractual, financial and clinical integration requirements are adhered to and achieved through provider education, provider training, collaborative problem solving and trend identification.

Position Duties

  1. Provider Network Operations
    • Researches and resolves incoming escalated provider inquiries within contract guidelines; educates providers on new protocols, quality metrics, clinically integrated organizational protocols, organizational policies, and procedures.
    • Schedules and attends visits with identified PCCN providers, nurses, referral coordinators, practice managers and other office staff at clinics in assigned territory to establish relationships.
    • Performs periodic audits of network practices to ensure adherence to network protocols and adopted clinical guidelines.
  2. Quality Improvement
    • Assists with the development and implementation of provider training programs, including but not limited to HEDIS and quality metric performance. Serves as the main PCCN provider training resource.
    • With support of data from the analytics team, monitors and analyzes Quality Improvement (QI) outcomes to ensure network goals, objectives, outcomes, accreditation and regulatory requirements are met.
    • Participates in various QI committees and work groups convened to improve process and/or health outcomes, and contributes meaningful detail based on functional knowledge.
    • Acts as an agent of change in the network and communicates the vision for change by sharing best practices and clinical pathways to support improved patient care, satisfaction and appropriate utilization of healthcare resources.
  3. Administrative Functions
    • Works independently to schedule time with practices and adheres to the schedule or updates as necessary in a transparent fashion to justify time out of office.
    • Documents encounters with each practice within one business day to maintain up-to-date, accurate, and complete visit details.
  4. Performs miscellaneous job related duties as requested.

Phoenix Children's Mission, Vision, & Values

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

  • Offering the most comprehensive care across ages, communities and specialties
  • Investing in innovative research, including emerging treatments, tools and technologies
  • Advancing education and training to shape the next generation of clinical leaders
  • Advocating for the health and well-being of children and families
Values
  • We place children and families at the center of all we do
  • We deliver exceptional care, every day and in every way
  • We collaborate with colleagues, partners and communities to amplify our impact
  • We set the standards of pediatric healthcare today, and innovate for the future
  • We are accountable for making the highest quality care accessible and affordable
The position has been closed or filled.

Please search our career site for positions that are currently active and accepting resumes at https://careers.phoenixchildrens.com