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Population Health RN- Remote

Apply Job ID 18181 Date posted Oct. 30, 2020 Location Newport News, Virginia Full Time / Part Time Full time (FT)

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QuadMed's dedicated health professionals focus on wellness and prevention, putting the patient at the center. Working as a team, we deliver high quality, integrated care while controlling ever-growing costs. QuadMed is an innovative leader in employer healthcare solutions, one of the fastest growing providers in the country. In partnership with our patients and the companies we serve, our mission is to create a culture of health.


GENERAL PURPOSE OF JOB 

The Population Health Nurse will focus on supporting both the clinical care team and population health services team in improving health outcomes across the population we serve.  This position will work closely with the QuadMed health and wellness center providers, medical assistants, and other QuadMed wellness services providers (i.e. CDE, RDN) on a daily basis.  S/he will utilize population health management tools, clinical disease guidelines for outreach, identification of care gap analysis in creating work plans for the population health nurse and team to address population health outcomes.  This role is responsible for working closely with the Clinic Staff, Clinical Quality, and Operations to enhance clinical quality outcomes on an individual patient level, assist patients throughout the continuum of care and at a population level.  This role will have direct accountabilities and collaborative responsibilities to achieved improvement in defined population health metrics.  The interactions of this role will encompass both patient and staff contacts.   

KEY RESPONSIBILITIES 

Analytic  

  • Assesses client’s overall population for health improvement opportunities to analyze data for trends in health outcomes, gaps in clinical care, and high risk high cost patient conditions (such as hospitalization, ER/UC, prescription medication trends) 

  • Researches best practices and methods along with clinical practice guidelines to improve processes that enhance clinic metrics and health outcomes 

  • Effective use of population health management tool to perform gap analysis on population (i.e.  chronic disease, prevention, social factors) 

  • Collaborates with clinical quality to generate meaningful and accurate population health reports, assuring linkage to corporate and client objectives, and performance guarantees  

  • Identifies and interprets data sets from sources such as raw claims files/EMR disease registry/clinic data warehouse 

  • Collaborates with corporate leadership to define the requirements and validate population health data reported at the provider, clinic, programming, and client level 

Work plan development and accountability 

  • Creates a strategic outreach program that is customized to their workforce, goals and budget; utilizes data (such as health assessment data, claim/utilization data, employee survey data, and biometric screening results) to provide outreach services 

  • Coordinates and performs regular, proactive outreach to patients according to their work plan 

  • Assists in the development of Quality Improvement studies 

Collaboration with patients , providers and health care team  

  • Collaborates with health and wellness center providers to identify high risk/target populations (i.e. high risk diabetics, noncompliant patients)  

  • Collaborates with certified diabetes educator, RDN, Wellness coordinator for targeted outreach 

  • Provides case management services by being a patient advocate, resource and contact person for patients and families assisting the clinical team’s RN in these endeavors 

  • Works as a community partner to improve linkages to outside resources 

  • Assesses, plans, directs and evaluates total nursing care as determined by the patient’s age-related physical, psychosocial, and cultural needs in accordance with established standards, policies and procedures of QuadMed and assigned client groups  

Other duties 

  • Acknowledges patient’s rights on confidentiality issues, maintains patient confidentiality at all times, and follows HIPAA guidelines and regulations 

  • Completes all documentation accurately, timely and efficiently for regulatory compliance; demonstrates skills necessary for proper documentation in the Electronic Medical Record; participate in quality improvement, continuing education, and other patient care programs established by the health center requirements for QuadMed and/or assigned client groups  

  • Scans and imports records, forms, etc. as necessary 

  • May perform occasional clinic nursing duties in the event of an employee illness or absence  

JOB REQUIREMENTS 

Appropriate education and/or experience may be substituted on an equivalent basis 

Education:  Requires a bachelor’s degree in nursing from an accredited college or university 

Experience:

  • Five (5) to seven (7) years of experience working in a clinical setting 

  • A minimum of three (3) years of experience in clinical data analysis  

  • A minimum of two (2) years of experience in care coordination, referral coordination, and/or population health management 

  • Chronic Case Management experience preferred 

Certificates, Licenses, Registrations:  

  • Requires a current, valid nursing license in the state of the position or compact state license required 

  • Requires current BLS Certification; PALS preferred

Additional Company Information 

We offer excellent benefits to eligible employees, including 401(k), holidays, vacations and more.

QuadMed and Quad is proud to be an equal opportunity employer and values diversity. We are committed to creating a place of belonging — a space where employees do not need to sacrifice who they are to exist and grow in our workplace. QuadMed and Quad does not discriminate on any unlawful basis including race, religion, color, national origin, disability, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or any other basis prohibited by applicable federal, state, or local laws. QuadMed and Quad also prohibits harassment of applicants and employees based on any of these protected categories.

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