Practice Support Specialist

Job Description

Under the direction of the Performance Programs Supervisor, the Practice Support Specialist is uniquely positioned to drive healthcare delivery transformation with Prospect Medical Group providers and staff at provider offices within Orange, Inland Empire, San Diego and Los Angeles counties. Through a combination of on-site visits (approximately 75% fieldwork and travel), remote visits, and e-mail contact, the Specialist supports physician practices with redesigning clinic-based care delivery workflows that allow the practice to implement care on a population level, improve patient experience, and transition to reimbursement for better health outcomes. The Practice Support Specialist is a key driver of this reform, providing boots-on-the-ground technical assistance to Prospect Medical Group providers through training on quality measures, documentation standards, analytics, and training so they can keep up with NQCA and DHCS quality standards.

Responsibilities

• Manage a caseload of physician practices to develop trust and support practices as they work on quality improvement projects.
• Conduct on-site and virtual visits with healthcare providers and their staff; document visits; and collect required documentation (Medical Records) to help close gaps via nonstandard supplemental data, and/or help the office with coding documentation.
• Provide education and training to health care providers and their staff on HEDIS/Star Measures to help organizational success in these areas.
• Monitor and track success of training and measure rates, by reviewing provider’s quality scorecards and Gap in Care Reports.
• Help assigned offices with increasing practice’s year over year pass rates; 50th percentile for Medicaid/Commercial Lines of Business, 4+ Star ratings for Medicare Line of Business.
• Coordinate and collaborate with internal departments to encourage proactive communication and solutions for efficient and effective progression for the office’s measure compliance rates.
• Access and incorporate all available resources, tools, and/or materials to support Performance Programs Department Initiatives.
• Assist providers in the identification of operational processes that hinder encounter data capture.
• Facilitate practice assessments, using the results to guide Physician practice development and development of SMART Goals.
• Identify opportunities for improvement in the operations of the organization and other processes in which team members are involved.
• Provide support for office redesign as needed (i.e. workflows, documentation, standard processes) to improve efficiency.
• Assist with Cozeva account creations and training as needed.
• Prepare, analyze, and interpret reports to communicate practice progress for both internal and external audiences.
• Prepare reports, track/monitor updates, month over month progress and review summaries for all assigned offices.
  
  

Qualifications

Minimum Education: High School Diploma or General Education Development (GED) required. Associate Degree preferred.

Minimum Experience: Two plus (2+) years of professional experience in administrative/clinical healthcare setting.

Req. Certification/Licensure: None.

"Location-Based Pay Adjustment"

About Us

With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.