CLINICAL OUTCOMES EDUCATOR Job: Details: CLINICAL OUTCOMES EDUCATOR Location: Methodist Health System Department: DMPN Management Schedule: Full-time Shift: Day Hours: 8:30/5:00 Job Details: * Associates Degree * Job Purpose: Reports to the Assistant Vice President (AVP) for Managed Care and assists in the development and ongoing implementation of the ambulatory, quality review initiatives established by DMPN, including participation in educational activities. Responsible for completing physician office site visits and ambulatory medical record reviews for physicians participating in Dallas Methodist Physicians Network (DMPN). Also responsible for credentialing and recredentialing physicians for participation in managed care organizations and providing physicians and their office staffs with education and written communication regarding the reviews. Serves as a liaison for managed care issues. Supports the mission, vision, values and strategic goals of Methodist Health System. Education Graduate from an accredited school of nursing. Licenses and/or Certifications Licensure as a Registered Nurse in the State of Texas Related Work Experience and Other Skills •Able to calculate using basic mathematical formulas (means, percentages, medians) •Able to develop and maintain good working relationships with all levels of staff, patients and family members •Experience in a physician’s office, hospital quality review department, managed care organization, or credentialing organization preferable •Maintains a professional approach in all situations •Must be able to compile and organize data •Organized to perform multiple tasks needing to be accomplished •Thorough knowledge of Microsoft applications including Excel, Word and Access. •Typing and computer skills preferred •Work Experience: 3 years’ experience Job Roles •Assists in the development and review of sample forms, sample guidelines, and other documents to be used by physicians in their offices to assist in meeting DMPN’s requirements. Distributes samples and educates physicians and their staff on their use. •Maintains knowledge of the National Committee for Quality Assurance (NCQA) Accreditation Standards, Texas Department of Insurance Quality Improvement Program (Sec. 11.1902), Occupational Safety and Health Administration (OSHA) guidelines, Clinical Laboratory Improvement Act (CLIA), the American with Disabilities Act (ADA), and other standard or guidelines that apply to a physician’s office practice. •Performs medical record reviews as part of DMPN’s ongoing ambulatory quality review initiatives as adopted by the DMPN Board of Directors. In conjunction with the AVP, develops a QI plan, analyzes information to identify areas for improvement, strategizes on the development of methods and processes for improvement, designs the presentation of the data, and assists in ongoing physician education. Collects and aggregates data from the reviews as well as other appropriate sources, and uses basic statistical analysis to document results and display data. •Performs structured physician office site visits and patient record reviews for all primary care physicians, all obstetricians/gynecologists, and other specialists as defined by DMPN according to the review schedule using established criteria as part of DMPN’s credentialing functions. Responsible for providing each physician with educational letters of the results of these reviews. •Provides consultation and education to physicians and their office staff on ways to meet the ambulatory quality review initiatives and patient record reviews. •Responsible for setting up appointments with the physicians and their staff. dlvr.it/6R3gHf
Posted on: Sat, 26 Jul 2014 11:18:40 +0000
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