Network Qual Perf Coord

Position Details

Department: PCCN | Phx Children's Care Network
Category: PCCN
Location: Telecommuting
Employee Type: Regular
Posting #: 721297
Posted On: 1/11/2023

Position Summary

The Network Quality Performance Coordinator (NQPC) is responsible for activities involving quality measures and compliance with applicable regulatory and contractual requirements. The goal of the NQPC is to work collaboratively with multiple health care professionals, patients, and families, and key internal stakeholders to identify and assist with closing gaps in care. The NQPC`s focus is in increasing quality metric compliance for our patient population, contracted providers, and associated health insurance plans. The NQPC will Identify patient barriers that prevent gap closure, such as transportation, language barriers, health literacy, etc. and work with internal and external stakeholders to remove these barriers, resulting in gap closure. The NQPC will be primarily focused on connecting with patients and practices that who have gaps-in-care related to PCCN’s contractual quality metrics. The NQPC will work with PCCN`s operational and clincal teams to achieve excellent performance, meaningful outputs, and adherence to compliance objectives. Network Quality Performance Coordinators are excellent problem-solvers who show initiative. They are highly organized and efficient, allowing them to work on multiple goals simultaneously and meet and exceed productivity benchmarks.

Position Duties

  1. Quality Management Support
    • Work alongside PCCN leadership and Network Quality Performance Manager to identify potential gaps in care, related to contractual obligations, within interrelated to medical, social, developmental, behavioral, educational domains as well as in their informal support system(s).
    • Contribute to the development and implementation of innovative approaches to address patient gaps-in-care specific to PCCN’s contractual quality measures.
    • Serve as an advocate for gap closures within the healthcare, behavioral health, and community systems.
    • Assist members and families with the identification of barriers preventing them from accessing care. And work together to develop ways to address these barriers.
    • Assist with appointment scheduling, locating a contracted pediatrician, and other tasks associated with successfully meeting contractual gaps in care measures.
    • Document all quality navigation interactions in Pediatric Care Constellation (PCC) system
    • Successfully coordinate with the Integrated Care Coordination, Practice Integration and Quality teams to meet goals.
    • Collaborate with physician office(s) and other agencies and programs to meet contractual quality goals.
    • Completes compliance reviews as directed
    • Meet with subject-matter experts to ensure specialized topics are appropriately addressed
    • Efforts to establish and maintain positive working relationships with both internal and external stakeholders
    • Work collaboratively with network practices in obtaining patient records and supplemental data to submit to partnered health plans
    • Works within a team to accomplish other duties on projects to meet necessary deadlines
  2. Customer Service
    • Communicates clearly in both written and verbal communications with all internal and external customers
    • Recognize and utilize appropriate verbiage and tone over the phone, in emails, or through text to facilitate engaging and professional patient/family relationships.
    • Responds to voicemails, emails, texts within 24 hours or one business day.
  3. Provider Integration
    • Work with contracted provider offices as well as the PCCN Practice Integration Team and Quality Manager to investigate current gaps in care.
    • Develop workflow to stay current on a regular basis with the status of gaps in care for our attributed members and practices.
  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.

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