Greenville, NC30+ days ago
Monitor the impact of value-based payment initiatives and quality report cares including use data analytics tools to measure baseline and set target goals, apply appropriate principles of risk stratification models, assess physician practitioner performance data ratings with measurement of reimbursement impact, utilize public and private comparative data to improve patient care, recognize the relationship of clinical documentation to quality scorecards and outcome; use predictive analytic models to identify potential risk factors, identify potential interventions to drive breakthrough improvement, assess revenue impacts associated with organizational quality performance, develop organization-specific key performance indicators on scorecard, present information to stakeholders regarding value of complete and accurate clinical documentation, patient management, and accountability. Collaborate with providers to ensure complete and timely documentation to maximize payment and minimize details; apply organization specific risk calculations when analyzing the utilization of services; communicate the impact of quality initiatives on payment and cost management; collaborate with stakeholders to improve cost recovery for healthcare entities and providers; present data demonstrating patterns and trends for quality measures; collaborate with appropriate stakeholders regarding participation in alternative payment models; participate in the payment control process; develop improvement plans including performance metrics in collaboration with finance, operations, clinical leadership and other key stakeholders; integrate mitigation plans with improvement plans to address barriers or challenges to implementation of change management/real-time actions.