Clinical Quality Liaison Lvn

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

***This position will be work from home within the region, with up to 50% travel in Kern, CA and Tulare, CA counties.

Position Summary:

The Clinical Quality Liaison educates and supports providers and practice sites in improving Clinical Quality measures and closing gaps in care. The Clinical Quality Liaison provides education Acts as a resource for HEDIS measures appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting compliance to meet State and Federal standards for HEDIS. Supports the development and implementation of quality improvement interventions and audits.
Travels to provider sites and clinics 50%-75% of the workweek.

Responsibilities may include:
- Advises and educates providers and practice staff in Clinical Quality measures medical record documentation and coding guidelines.
- Collects summarizes and trends provider performance data to identify opportunities for provider improvement and closing gaps-in-care.
- Supports provider practices in coordinating gaps in care with members.
- Reports provider/clinic specific metrics. Identifies specific practice needs and barriers to Clinical Quality improvement. Develops action plans to address the needs and barriers in collaboration with providers.
- Performs medical record review or audits as needed.
- Document provider clinic staff member and/or health plan encounters.
- Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
- Provides resources on Clinical Quality measures to support providers and clinic staff.
- Communicates with and researches external data sources as needed. Provides communication such as newsletter articles member education outreach interventions
- Update data and maintain data integrity in the population health platforms and EHR systems.
- Performs other duties as assigned.

Minimum Qualifications:

- Required or equivalent work experience of 2 years related HEDIS record collection and measures improvement with analytical review/evaluation and / or Quality Improvement. Experience in data and chart reviews to provide consultation and education to providers and provider staff.
- Clear and current CA Licensed Vocational Nurse (LVN) license

Preferred Qualifications:

- 1 year of experience in Managed Care.
- Associate’s Degree or higher in Healthcare Public Health Nursing Psychology Health Administration Social Work or related field.

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