Primary City/State:

Phoenix, Arizona

Department Name:

Clinical Performance Improveme

Work Shift:

Day

Job Category:

Clinical Care

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position provides a variety of clinical support functions to contribute to the overall improvement of healthcare quality of life as well as efficient use of resources. Also to ensure patients receive referrals or information about the right services needed at the right time, whether acute care or ambulatory. This position assists with setting up outpatient services or providing resources to help the patient maintain optimal care. This position monitors health plan members and patients from inpatient to ambulatory to ensure they are receiving services they need or are continuing to be offered services if there are any changes. Performs administrative tasks (indirect care) that support the care team in direct medical care and utilizes the EHR, external resources, and tools to provide a complete assessment of the patients health status which includes identifying care gaps. Utilizes specialized knowledge, judgment and communication skills to ensure the members get the indicated care when and where they need and want it. Patient outreach is a critical component to this position.

CORE FUNCTIONS
1. Works with the patient to coordinate services into or out of a care setting in order to obtain appropriate services and benefits in collaboration with patients or clinical staff. Performs referrals or tasking other departments, coordinating home health care, confirming arrangements, making physician or outpatient appointments.

2. Reviews available information obtained by healthcare team members in one of many locations. Considers physical, cultural, psychosocial, spiritual and age specific and educational needs of the patient. Performs follow-up calls to patients and providers regarding their experience and issue resolution and reviews patient data/demographics etc. to reflect changing patient needs and provide input on updates as needed.

3. Assists with patient navigation through the healthcare system by connecting the member with information or services. Recognize issues with members health status and reports abnormalities or needs to a licensed professional. Promotes continuity of care by accurately and completely communicating with other care givers the status of the patient. Bridges gaps between the member and the clinical team including but not limited to the following, connection to services, needs, barriers etc.

4. Participates in departmental improvements, Banner initiatives and performs data collection for measurement of projects. Identifies any care gaps based on preventative and maintenance care guidelines as obtained through data review, dashboards, chart auditing etc.

5. Documents accurately and timely all interventions and necessary patient related activities in the correct medical record. Utilizes EHR to provide outreach for patients in respective preventative care or chronic care (high risk patients) and those not seen recently by a healthcare provider. Actively works reports to close care gaps and document findings.

6. Works collaboratively with team members; promotes collaborative relationships with vendors, community and referral resources.

7. May perform tasks such as may provide information on community resources/information or other tasks as related to clinical specialty. May perform secretarial/cross coverage where needed.

8. Works under general supervision. Confers with supervisor on any unusual situations.. Internal customers: All levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External Customers: Home health agencies, nursing homes, insurance providers, volunteer services, county and governmental agencies and medical supply companies.. Licensed health professionals are available and indicate process for the oversight. For initial screening, the organization limits use of non-clinical administrative staff to the following; Performance of review of service request for completeness of information, Collection and transfer of non-clinical data, Acquisition of structured clinical data, Activities that do not require evaluation or interpretation of clinical information. The organization ensures that licensed health professionals are available to non-clinical administrative staff while performing initial screening.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

SUPERVISORY RESPONSIBILITIES
DIRECTLY REPORTING
None
MATRIX OR INDIRECT REPORTING
None
TYPE OF SUPERVISORY RESPONSIBILITIES
N/A

Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner.

PHYSICAL DEMANDS/ENVIRONMENT FACTORS
OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager)
Requires extensive sitting with periodic standing and walking.
May be required to lift up to 20 pounds.
Requires significant use of personal computer, phone and general office equipment.
Needs adequate visual acuity, ability to grasp and handle objects.
Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone.
May require off-site travel

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

The position requires a proficiency level typically achieved with three years of experience in healthcare as a Nursing Assistant, Medical Assistant, Health Unit Coordinator, Patient Care Tech, etc.

Current CNA, CHW, MA certification, or LPN license in state of practice may be required. Requires an understanding of medical terminology including clinical technology, processes and EHR. Must demonstrate effective communication skills, human relations skills, strong organizational and time management skills and flexibility in responding to multiple demands

PREFERRED QUALIFICATIONS

Bilingual, preferred in some assignments.

Additional related education and/or experience preferred.

DATE APPROVED 06/15/2015

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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