Collaborate to develop a trusting partnership with clinical providers and practice locationsIdentify opportunities to improve health outcomes for CKD and ESRD members based on provider specific dataIncorporate education and communication on Best Practice sharing for identified areas of provider low performanceProvide assistance in identifying areas for process improvement in provider office workflowsPartner with physicians/physician staff to identify members that would benefit from Care Navigation supportSupport operational and clinical stakeholders in the identification, development, and execution of process improvement initiativesCollaborate with Provider Relations Manager to improve provider performance in areas such as Healthmap Solutions Interventions, Care Gaps, and Chronic ConditionsEducate providers on HEDIS measures and open Care GapsSupport the development and implementation of quality improvement interventionsIdentify opportunities to educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, Renal Replacement Therapies, etc.Build strong cross-functional relationships with internal departments and provider partners and practice staffCollaborate with the Care Navigation team to provide and receive information to enhance care coordination on Healthmap Solutions membersMaintain thorough documentation of all provider meetings and interactions for consistency and coordination of provider engagementMaintain documentation in compliance with National Committee for Quality Assurance (NCQA) standardsEnsure timely and successful delivery of reports to internal and external stakeholdersPerform other related duties as assigned

Partnering with facilities and providers to develop post-acute care network strategies that focus on improving the continuum care. Focusing on Medicare BPCI participants.

Managing 11 primary care offices and 30+ RN/LPN/MAStaff scheduling, ordering office vaccines, prior authorization, training new nurses/medical assistancesMonthly office audits- working directly with office managers to ensure practices are in a full operational status. Approving PTO, coordinating coverage, filling in as needed. Filling in for call-offs, working directly with physicians- rooming patients, vital signs, EKG, ear flushing, assisting PAP smear, ordering medications and labs, IM injections, medication reconciliation, Medicare wellness visits, drug screens.

Marketing the building in the community, giving tours to the potential families and residents. Assessing the potential resident prior to admission to ensure that all needs will be able to be met if this facility is the chosen one. Admission paper work, moving in, getting comfortable and helping the resident feel as though they are home!