Provider Team Lead

Job Title: Provider Team Lead                        

Exempt Status: Exempt

Position Type: Full-time

Division: Clinical Services                  

Reports to: Director, Clinical Services

Location: Honolulu, HI

Episource, with over 3,000 employees worldwide, is a leading provider of risk adjustment services and solutions for health plans. Our services help Medicare Advantage, Commercial/Exchange, and Medicaid managed care plans improve and support accurate reimbursement in a post-Affordable Care Act market. Our services include retrospective chart reviews, medical record retrieval, HEDIS/ACO quality reporting, and data analytics, allowing payers and providers to dramatically reduce costs and improve quality of care.

Job Summary:

The Provider Team Lead is a regional position to oversee provider onboarding, conduct training and coaching sessions for new providers, support Clinical Services department in monitoring and improving provider performance and act as a liaison between Episource and the Client to improve and facilitate project outcomes.

Responsibilities:

  • Conduct in-person training sessions with new providers in region
  • Support Clinical Services team in conducting remote trainings for new providers across the State
  • Provide mentorship and coaching to providers in region
  • Shadow 2-5 visits for new providers in region during their first 2 weeks of field work
  • Shadow 1-2 visits for all providers in region twice per year (once every 6 months)
  • Function as a Liaison between the Client (MDX Hawaii) and Episource Management and the provider team
  • Meet with MDX project Management Team as needed
  • Attend weekly Episource / MDX project calls
  • Meet with MDX Participating Providers in the field as needed – to provide education regarding the Episource Health Risk Assessment project
  • Work with the Episource and MDX Project Management Teams on the implementation of Health Fairs, Medicare Shop and Compare event, and other events and activities as needed
  • Monitor performance of providers in region
  • Random review of 5 charts per month of existing providers – provide each provider with a “report Card” of results of their individual review and provide a monthly report to Clinical Services Team for further follow up and education of provider as indicated
  • Review of all charts completed by New providers for the first 2 weeks of employment with a one hour per week telephonic review of documentation and provide a summary of findings to Clinical Services Team
  • Schedule & oversee in-person monthly provider team meetings
  • Schedule and conduct weekly Team Meeting via remote /webinar / telephonic meeting
  • Proficient in all diagnostic testing for the Project (such as DRE and Quantaflo) and provide local support to the Provider Team regarding these diagnostic tests
  • Manage equipment for all Providers in Hawaii: collect equipment upon resignation and re-distribute to new providers, keep inventory of all medical supplies and diagnostic equipment
  • Work with Clinical Services team to support ongoing provider education and performance/quality improvement
  • Work with the Director of Clinical Services and Human Resources to guide providers through Performance Improvement Plans and the Progressive Disciplinary policy as necessary
  • Continue to provide a minimum of 12 HRA visits per week availability

Education / Requirements:

  • Nurse Practitioner
    • Advanced Practice Registered Nurse (APRN) degree, Master’s degree in Nursing (MSN), or higher (DNP or PHD in Nursing)
  • Physician’s Assistant
  • Bachelor’s Degree or Master’s Degree for Physician Assistants from a NCCPA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessors.
  • PA License obtained after taking the Physician Assistant National Certifying Examination (PANCE).
  • Strong computer skills, familiar with Microsoft office
  • Ability to operate an Apple IPad
  • Strong Professional level of knowledge and comprehensive clinical assessment skills in the adult population and chronic disease management.

Certification or License:

  • Current Licensure free of disciplinary actions
  • AANP or AANC Certification
  • CRNP License
  • PA License
  • MD
  • Approved Specialties:  FNP, ACNP, ANP, AGNP (not all-inclusive)

Experience:

  • Minimum of 6 months experience and/or 40 total completed HRA visits as an Episource (or former Peak) provider
  • 1 or more years’ experience in patient care or clinical work
  • 1 or more years’ experience providing home health care visits.
  • 1 or more years’ experience performing physical examinations, performing diagnostic tests and screenings, and developing treatment plans.

Knowledge, Skills and Abilities:

  • Strong attention to detail
  • Ability to work with all levels of the organization
  • Ability to educate others on system applications and functions
  • Ability to handle tight deadlines

Work Environment:

The work will be done in patient homes, home office, meeting locations TBD (such as : MDX office or meeting venue) and travel will be required – on Oahu and neighboring Islands as well as occasional travel to CA (Episource Gardena, CA office).

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 200 pounds with assistance.

Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

EEO POLICY STATEMENT:

Episource, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Episource, LLC complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation, and training.

Episource, LLC expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Episource, LLC employees to perform their expected job duties is absolutely not tolerated.