The Clinical Community Liaison is responsible for serving as the point of contact and coordinator of care hand off with external hospital providers. The Liaison will primarily work to develop a solid approach to identifying and coordinating transition of care for chronic kidney disease members. This position will closely partner with Provider Relation Managers (PRMs,), Quality Practice Advisors (QPAs) and Care Navigation teams to improve the quality of the Kidney Health Management clinical program.
Responsibilities:
Ability to build positive, productive relationships with care teams, service providers, and coordinators of support
Collaborate with the assigned hospitals to develop a trusting partnership with clinical providers and interdisciplinary team members
Interact clearly and professionally with members and their families while gathering additional information related to their kidney health and build bridges to care navigation
Collaborate with Quality Practice advisors and Care Navigators to facilitate transition of care hand off at time of discharge
Facilitate the flow of information collaborates with the Care Navigation team to enhance care coordination on Healthmap Solutions members
Identify members timely and coordinates consent and hand off to care navigation
Identify opportunities to improve health outcomes for Healthmap Solutions members based on provider specific data
Incorporate education and communication on Best Practice sharing for identified areas of provider low performance
Provide assistance post discharge in identifying areas for process improvement in provider office workflows
Support operational and clinical stakeholders in the identification, development, and execution of process improvement initiatives
Partner with physicians/physician staff to identify Healthmap Solutions members that would benefit from Care Navigation support
Function as a resource for and identifies opportunities to educate hospital teams on topics related to Chronic Kidney Disease, End Stage Renal Disease, Renal Replacement Therapies, etc.
Build strong cross-functional relationships with internal departments and discharge planners
Maintain thorough documentation of all provider meetings and interactions for consistency and coordination of provider engagement
Maintain documentation in compliance with National Committee for Quality Assurance (NCQA) standards
Ensure timely and successful delivery of reports to internal and external stakeholders
Perform other related duties as assigned
Requirements:
Bachelor’s degree in nursing required
Active, unrestricted RN license required
3 years of experience in a health care or managed care setting
3 years of experience in claims or gap closure campaigns, preferred
3 years of progressive experience in healthcare services, clinical operations, quality, or care management
Prior experience building and managing relationships with health care providers preferred
Proof of valid and unrestricted driver’s license required. This position requires travel within assigned region to visit hospital providers
Same state residency required
Must be familiar with local healthcare market
Skills:
Excellent verbal, written and presentation, skills
Interpersonal skills to develop and maintain strong internal and external relationships
Ability to multitask, prioritization, and create solutions in a fast-paced environment
Strong critical thinking and analytical skills
Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint
