Careers

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Eastside Health Network is currently hiring for the following positions! Please review the job description and follow the link to apply for one of these exciting opportunities


CLINICAL/NURSING

Director of Care Management:  

The Director Population Health Care Management provides clinical leadership and strategic direction in the design, development, implementation and operations of innovative approaches to ambulatory clinical management with a focus on current and future accountable payer models to include, incentive-based, shared and risk-based, including full risk within Eastside Health Network (EHN)

This Director is responsible for the development and oversight of the population-based clinical care management and utilization program for EHN contracts, ensuring appropriate levels of staffing, effective and efficient teams, a sound infrastructure and appropriate policies to produce excellent outcomes

The Director of Population Health Care Management engages and collaborates with internal and external stakeholders, to include network and hospital leadership, EHN committees, hospital care management teams, physicians, payers, local and national organizations on methods and best practices of identifying and improving patient health outcomes, patient satisfaction and efficiencies

This Director is accountable for achieving established performance targets, goals, standard work, protocols, documentation standards and outcome reporting for all programs

 The Director of Population Health Care Management ensures that the department is in compliance with all applicable payer standards and contracted requirements, ensuring all work is meeting short term and long-term goals that will be achieved in a manner that is consistent with the mission, values and strategic goals of the network and health system

Primary Duties:

  • Provides day to day direction to the Care Management and Utilization Management teams (Care Managers, Ambulatory Social Workers and related support staff) to meet network targets, goals and objectives. Identifies opportunities for process improvement. Integrates, coordinates and collaborates with all disciplines along the continuum of care, including clinics, owner and independent providers, hospital departments, EHN committees, and payer partners to develop work flows, reporting mechanisms, and communication pathways to improve patient and network outcomes. Develops and updates policies and procedures. Acts as a role model to implement necessary change
     
  • Ensures that members are identified through risk stratification, utilization, referrals or identified by payers for care management/disease management and have a comprehensive care management plan, utilizing the case management process (Assessment, plan, implementation, monitoring and evaluation). Utilizes clinical standards for closing care gaps, standard work pathways, performing episodic care management, transitions of care and chronic disease management. Involves patients, families, physicians, healthcare team members and payer representatives as appropriate
     
  • Establishes and maintains documentation standards that optimally provide for effective and efficient delivery of patient care. Ensures that interventions, visits, and referrals are documented in the appropriate information systems
     
  • Develops and manages operational budgets, establishing appropriate staffing levels consistent with targeted productivity. Reviews caseloads and adjusts as appropriate for efficient, effective services utilizing regulatory standards, and maintaining budget allocations
     
  • Recruits and selects new staff. Provides and holds staff accountable to orientation, education, mentoring and training, both verbally and in writing, to include health plan contract and operations information, along with specific competencies of job functions. Provides performance reviews and performance improvement activities in a timely manner, to include discipline, corrective action plans up to and including discharge. Creates a collaborative team working with all disciplines along the continuum of care which impact care management and utilization management outcomes
     
  • Directs the processes necessary for data collection, data review, analysis, decision-making, report maintenance and reporting of pertinent integrated information, reports and dashboards. Monitors and tracks utilization trends and variances. Implements process improvement strategies and corrective action plans as appropriate to improve health outcomes, decrease of cost of care and improved efficiencies
     
  • Maintains comprehensive working knowledge of payers, including incentive and risk-based contracts and regulatory requirements assuring that all care management and utilization management functions and strategies meet Health Plan and Regulatory requirements. Maintains knowledge of Local and National best practices for care coordination/navigation, case management, utilization management, and disease management, to support effective population health strategies and tactics
     
  • Maintains thorough working knowledge of provider performance, reporting, registry tools, and databases to support performance. Monitors, interprets, and reports on changes in performance, patient trends, provider actions, and payer reports that may impact network goals and outcomes
     
  • Provides support and/or leadership for key network meetings which could include Board, Network Provider, Utilization, and Payer meetings
     
  • Leads, assigns, and/or participates in special projects and assignments as required
     
  • Performs other duties as assigned

To find out more about position, follow link:
https://jobs.evergreenhealth.com/job/kirkland/director-population-health-care-management/437/14915702


PROFESSIONAL/TECHNICAL

Financial Analyst:

The Financial and Managed Care Analyst is responsible for assisting with the data and analytical aspects of contracts and financial management. Position provides evaluation of managed care contracts and general financial analytical work utilizing SQL, Tableau, Excel and/or other analytical tools and supports the Eastside Health Network’s operational and financial reporting needs, including general analysis, budgeting, monthly performance reporting, and distribution of flow of funds to EHN participating practices

The Financial and Managed Care Analyst monitors contract performance and other key contract statistics for periodic reporting, completes ad hoc analysis to support business needs, and assists in the development of specific contracting strategies

Primary Duties:

  • Manages Eastside Health Network (EHN) financial activities related to flow of funds, settlements and practice distributions
     
  • Responsible for monthly EHN financial and performance reporting related to budgeting, banking and other routine activities
     
  • Understands and interprets contract terms, reimbursement schedules, patient accounting system(s) and other sources of data to complete analyses and financial projections
     
  • Develops and maintains databases and spreadsheets
     
  • Develops and completes specialized statistical and financial analysis reports on payer volumes, payments, contractuals, administrative fees, etc.
     
  • Performs other duties as assigned

 To find out more about position, follow link:
https://jobs.evergreenhealth.com/job/kirkland/eastside-health-network-managed-care-financial-analyst/437/14955818

 

Risk Coder:

The person in this role will accurately review, interpret, audit, code and analyze medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. This may include outpatient treatment, professional, and/or limited inpatient medical services, according to ICD-10 CM coding guidelines, and risk adjustment model regulations. This position will coordinate and collaborate with operational and clinic leadership to assist in identification of clinical best practices and implementation of process improvements, related to coding, in order to appropriately document and capture the risk burden of patients 

Primary Duties:

  • Review/audit medical records for completeness, accuracy and compliance with applicable CMS Risk Adjustment coding guidelines and regulations
     
  • Identify, compile and code patient data, using ICD 10-CM and other standard classification coding systems and report findings to Government Programs Manager
     
  • Develop/support formal educational activities for providers/practices as necessary as a subject matter expert on coding review/guidelines. Education to be provided in both a one-on-one or group setting to staff and providers on coding and documentation
     
  • Assist Government Programs Manager in developing documentation and coding improvement tools for designated providers/practices as applicable
     
  • Ensure compliance with relevant regulations, standards and directives with coordination from the OHMC/EHMG Compliance Department and OMC/EH Operations
     
  • Accountable for assigning ICD 10-CM/CPT/HCPCS codes and modifiers which generate reimbursement
     
  • Adhere to EHN, OHMC and EH security and confidentiality policies and procedures
     
  • Perform other duties as assigned

 To find out more about position, follow link:
https://jobs.jobvite.com/overlakehospital/job/oNT3bfwE