Value Care Coordinator

Piedmont Health Services, Inc. (PHS) is a 501(c)(3) nonprofit and Federally Qualified Health Center (FQHC) in North Carolina. Dedicated to delivering top-tier, accessible, and inclusive primary healthcare, PHS has proudly served for 55 years and remains the largest community health center in central NC. Operating 11 Community Health Centers, 2 PACE (Program of All-Inclusive Care for the Elderly) Senior Care facilities, and 2 Mobile Health Units, PHS extends its services to residents across five counties, including Alamance, Caswell, Chatham, Orange, and Lee.

Federally Qualified Health Centers (FQHC) are community-based healthcare providers that receive funds from the Health Resources and Services Administration (HRSA) Health Center Program to provide primary care services in under-served areas.

• Medical, Dental, Vision, Life Insurance (Short & Long Term Disability)
• 403(b) Plan
• Paid Holidays
• CME (Continuing Medical Education)

• Work Location:
  
  2525 Meridian Parkway - Suite 400, Durham, NC 27713 (PHS Administrative Office)
• Work Schedule:
  
  Monday through Friday, 8:00am to 5:00pm

Job Summary:

The Value Based Care Coordinator (VBCC) bridges the gap between patients, Piedmont Health Services, and insurance networks to close open care gaps, support transitional care and improve overall health outcomes. This role is dedicated to monitor performance metrics, supplies insurers the supporting documentation requested, ensure chronic conditions are assessed and documented annually as well as conduct patient outreach to close open care gaps.

The VBCC will meet regularly with insurance network representatives to discuss measure performance, incentive opportunities and recommended actions. The VBCC will monitor and track payor attribution assignments and assist with quality improvement projects, as well as provide performance data to Population Health Leadership, Quality and Clinical teams at departmental or site meetings. Additionally, the VBCC will conduct chart reviews to verify care gap reports and attempt to close the verified care gaps by conducting patient outreach and scheduling.

• Obtains and uploads documents into the population health platforms database.
• Assists with care gap assessments and closures.
• Conducts chart reviews to verify care gap data reports.
• Submits supplemental data to health plans to provide documentation of gap closure.
• Meets and collaborates with payor representatives
• Collaborates with the care team and Population Health Mananger in quality improvement projects.
• Ensures urgent issues are shared with care team.
• Conducts care gap outreach and scheduling.
• Participates in all assigned meetings.
• Adheres to privacy and security policies to ensure patient and company data is properly safeguarded. Follows company policies and HIPAA regulations.
• Meets productivity and role expectations, and addresses requests in a timely manner.
• Other duties, as assigned.

• High school diploma or equivalent, required.
• Bachelor’s degree in social work, healthcare administration, human services, public health or related field, preferred.
• 2 years of experience in a healthcare organization, required.
• 1 – 2 years of case management, social work, or relevant work experience, preferred.
• Bilingual, preferred.
• Maintains a valid driver’s license with auto liability insurance.

• Knowledge of and experience working in patient data systems.
• Proficient with MS Office.
• Knowledge of state and federal benefits systems.
• Excellent communication skills – oral and written.
• Excellent organizational and…