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Primary Care Representative

    Highlights

    Provides outreach and education to primary care practices by assessing practices along the continuum of transformation, focusing on identifying performance measures, and creating and implementing relevant quality improvement work plans to address gaps in care. Incumbent works directly with healthcare practices to build positive relationships, ensure effective education and reporting, and to proactively identify performance improvement opportunities through analysis and discussion with subject matter experts.

    Numbers & Facts

    LocationLittle Rock, AR
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    Description

    To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here.

    Job Summary

    The Primary Care Representative educates and supports primary care practices in making improvements in quality, utilization, cost of care, and patient experience measures. Incumbent works directly with healthcare practices to build positive relationships, ensure effective education and reporting, and to proactively identify performance improvement opportunities through analysis and discussion with subject matter experts. Incumbent is a team player and supports team members to ensure the team meets its goals.

    Requirements

    EDUCATION

    Bachelor's degree in Business, Healthcare Management, Health Administration or other health-related field. In lieu of degree, five (5) years' clinic leadership experience, which includes quality improvement experience will be considered.

    LICENSING/CERTIFICATION

    Valid Driver's license with the ability to travel, as necessary, within the designated service area required.

    EXPERIENCE

    Minimum three (3) years' quality performance improvement involving coaching, consulting and operations experience in a health plan, managed care setting or clinical environment.

    Project management or program management experience required.

    Knowledge of and experience using EHR's and building reports for quality improvement.

    Experience in the health care field, particularly in a clinical environment, with experience in program development and utilization management is desirable. Patient-Centered Medical Home, Primary Care First, ARHome, or other CMS Value Based Model experience preferred.

    This position will require to be in the office on Monday's

    ESSENTIAL SKILLS & ABILITIES

    Leadership

    Collaborative Team Member

    Results-Oriented

    Interpersonal Communication

    Oral & Written Communication

    Coaching

    Facilitation

    Presentation Speaking

    Needs Assessment

    Partnership Building

    Analytical Analysis

    Influence Others

    Skills

    • Business Compliance
    • Coaching
    • Collaborative Communications
    • Conflict Resolution Management
    • Consultative Approach
    • Cross-Functional Communications
    • Customer Relationship Management (CRM)
    • Data Analysis
    • Data Management
    • Employee Engagement Strategies
    • Information Interpretation
    • Information Ordering
    • Interpersonal Relationship Management
    • Oral Communications
    • Persuasion
    • Public Speaking
    • Systems Analysis
    • Training Instruction
    • Written Communication

    Responsibilities

    • Analyzes data and reviews trends, challenges, and barriers regarding practice performance to develop and inform improvement plans in desired timeframe and identify opportunities for shared learning events
    • Identifies and shares Electronic Health Record (EHR) optimization practices and ways to utilize data to achieve improvement in healthcare delivery systems, processes, and outcomes
    • Leads training events and other group sessions to improve the skills and knowledge of practice leadership, clinicians, and other frontline staff
    • Other duties as required
    • Provides outreach and education to primary care practices by assessing practices along the continuum of transformation, focusing on identifying performance measures, and creating and implementing relevant quality improvement work plans to address gaps in care.
    • Stay abreast of new developments and industry trends related to quality improvement, clinical best practices, quality metrics, service excellence and practice transformation
    • Supports the development and dissemination of relevant quality improvement project materials and communications
    • Willingness to travel in service region, estimated 75%

    Certifications

    Security Requirements

    This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

    Segregation of Duties

    Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

    Employment Type

    Regular

    ADA Requirements

    1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

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