Working closely with the Market-based Population Health teams, primary care providers (PCP鈥檚), networked partners, and operations team at Privia Health, the Clinical Quality Associate will provide ownership and execution on defined Value-Based Care program performance metrics and support for Privia鈥檚 at-risk patients within a defined region. Primary work will include completing quality audits, providing context for provider education, patient outreach to provide coordination services, fill gaps in care, payer attestations, and regular review and action on local performance reports and regional action plans. The candidate will have relevant clinical experience, educational background or license/certification to support the Quality Management team.
- Collaborate with local teams to define performance metrics
- Own the execution and proactively resolving issues and performance toward defined performance metrics
- Review patient non-compliance reports to ensure timely disease specific and wellness visits
- Identify concerns and demonstrates critical thinking to determine plan of action and/or support care centers
- Subject matter expert on all requests related to population health and quality measure specifications.
- Analyzing payer reports and determines what information is shared back to care centers
- Provide education and assistance with patient self-management goals
- Make appropriate referrals to internal care team, payer programs, community resources, home care, and disease management programs
- Perform necessary payer attestation and performance reporting through payer portals
- Operate independently to achieve agreed upon goals
- Collaborate effectively with both internal and external teams to support population health and quality metrics
- Diligently maintain HIPAA and HR training, knowledge base and compliance at all times
- Manage and lead detailed special projects and communicate status to the client and Privia management team
- perform other duties as assigned