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Registered Nurse – Quality Improvement Director
Essential Job Functions
- Responsible for developing, implementing and monitoring quality management policies and procedures for quality data collection and reporting on HEDIS, UDS, Meaningful Use and PCMH measures.
- Conduct ongoing assessments of the existing eligibility and referrals, case management, disease management systems, and Quality Management programs within each clinic. Provide objective evaluation and recommendations for those systems.
- Review existing clinic information system capabilities for the tracking and monitoring of quality indicators. Make the necessary adaptations for standardized reporting across all clinics.
- Identify best clinical and business practices within the clinics. Recommend standardized systems and develop a plan to implement and monitor systems within and across the member clinics.
- Report audits requiring clinical judgment and expertise to the Medical Directors of the regional clinics, CCHN Quality Management Committee and other entities, as assigned.
Education and Requirements:
- Current California RN licensure.
- Basic computer skills are required –Microsoft Office including Word and Excel
- Experience working with chronic medical conditions such as diabetes, HTN, CAD etc.
- Experience documenting in EMR
- Experience working as a member of a multi-disciplinary team.
- Knowledge of PCMH, Meaningful Use, UDS, and HEDIS is a plus
- Experience in case management is a plus
- Motivational interviewing skills is a plus
- Experience in Behavioral Health is a plus
- Must have a working knowledge of current treatments with focus on chronic disease management
- Knowledge of the influence of cultural and spiritual values on health care.
- Basic knowledge of available health care and community resources appropriate for populations served.
- Strong clinical assessment and critical thinking skills necessary to serve patient population with complex medical, emotional and social needs.
- Ability to work independently with minimum of direction, to anticipate and organize work flow, to prioritize and follow through on responsibilities.
- Excellent verbal and written communication, interpersonal, problem-solving, conflict resolution, time management, positive personal influence and negotiation skills
- Ability to work respectfully and creatively with clients of diverse functional abilities, social, economic, and cultural backgrounds to support both client autonomy and client safety.
- Demonstrated skills in motivating, mentoring, coaching and educating clients with various necessary medical, social and functional interventions.
Job Type: Full-time
RESPONSIBLE TO: MEDICAL DIRECTOR
Responsible for examining, diagnosing and treating patients in accordance with recognized community standards. Physicians are members of patient-centered care teams.
DUTIES AND RESPONSIBILITIES:
- Assists in monitoring and approving the appropriateness of the pharmaceutical prescriptions of the midlevels and performs chart review on their medical records.
- Examines, diagnoses, and treats patients in accordance with recognized community standards.
- Orders laboratory tests, x-rays, consultation and diagnostic tests for patients as appropriate.
- Adequately documents care provided in the patient’s medical record immediately following each visit.
- Provides appropriate clinical information on patient visits to permit appropriate grant or insurance billing.
- Provides on-call telephone triage as scheduled.
- Adheres to the IBCC Mission, Vision, and Values, Standards of Conduct and HIPAA principles.
- Consistently adheres to and/or exceeds IBCC’s communication guidelines and expectations with patients, peers, and supervisor
- As an integral part of a patient-centered care team, solicits and respects patients’ values and preferences; ensures patients are recognized as members of their care team and have an active voice in decisions about their care; builds positive relationships with patients and staff, and participates in patient-centered medical home team meetings and trainings
- Participates in continuous quality improvement activities
- Possesses license to practice medicine in the State of California.
- Board Certified or Board Eligible in Family Practice or Internal Medicine.
- Two years experience as provider in an outpatient clinic, preferably community-based.
- Excellent communication and inter-personal and teamwork skills.
- Able to relate to culturally diverse patients and community.
- Adheres to the IBCC Mission, Vision, and Values, Standards of Conduct and HIPAA principles
Consistently adheres to and/or exceeds IBCC’s communication guidelines and expectations with
patients, peers, and supervisors. Greets every patient with a verbal greeting, eye contact and a smile. Communicates effectively by using welcoming words, proper tone of voice appropriate body language, eye contact and smiling in patient interactions. Listens skillfully and displays a willingness and ability to
- acknowledge patient needs, expectations and values using reflective listening and empathy conveyance. Responds to patient needs in ways that are helpful and beyond expectation.
- Collaboratively works with patients to positively affect their health outcomes.
- Builds positive relationships with other staff to maximize accessibility of care to all patients.
- Participates in continuous quality improvement activities and patient-centered medical home team meetings and training, and is receptive to accepting other job duties as assigned and as delegated.
Job Type: Full-time
Care Coordination Patient Services Representative
RESPONSIBLE TO: DIRECTOR OF CARE COORDINATION
Field phone calls for Care Coordination Department to answer questions and resolve basic issues related to referrals.
KNOWLEDGE: Customer service related to phone calls, medical front office practices, basic computer operation.
DUTIES AND RESPONSIBILITES:
- Maintain customer service phone etiquette by communicating effectively using welcoming words, proper tone of voice in patient interactions. Listen skillfully and display a willingness and ability to acknowledge patient needs, expectations and values through the use of reflective listening and empathy conveyance. Respond to patient needs in ways that are helpful and beyond expectations.
- Utilize HIPAA protocol for answering questions and in contacting patients.
- Fax referrals, imaging orders, and lab results to specialists and call to confirm receipt of faxes.
- Send messages via EHR that include the CPT code, fax and phone number.
- Find specialists’ information in Practice Management system, as needed.
- Resend letters to patients, confirming accurate address.
- Document actions and conversations in referrals.
- Schedule patient appointments.
QUALIFICATIONS: Aptitude for skilled personal communication is mandatory.
- Strong written and verbal skills, type 45+ wpm.
- Heavy phone experience.
- Ability to work well with people and communicate effectively and respectfully in English or Spanish.
- Strong organizational skills.
- Able to be flexible with roles.
Patient Services Representative
The Patient Services Representative (PSR) is responsible for advancing the quality of healthcare through exceptionally good customer service and communication with patients, using IBCC’s guidelines for communication. The PSR is also responsible for accurate data entry into the practice management and/or clinical systems. The PSR duties are shared and involve tasks associated with efficient flow of patients, such as answering phones, making appointments, and registering patients. PSR’s are members of patient-centered care teams.
Essential Duties and Responsibilities
- Adheres to the IBCC Mission, Vision, and Values, Standards of Conduct and HIPPA principles
- Consistently adheres to and/or exceeds IBCC’s communication guidelines and expectations with
patients, peers, and supervisors. Greets every patient with a verbal greeting, eye contact and a smile. Communicates effectively by using welcoming words, proper tone of voice appropriate body language, eye contact and smiling in patient interactions. Listens skillfully and displays a willingness and ability to acknowledge patient needs, expectations and values through the use of reflective listening and empathy conveyance. Responds to patient needs in ways that are helpful and beyond expectation.
- Collaboratively works with patients to positively affect their health outcomes.
- Orients all patients to clinic policies regarding their selection of their primary care provider, IBCC’s team-based care approach, services offered, appointment system, after hours’ coverage, collection policy, etc.
- Builds positive relationships with other staff, providers, and supportive departments to maximize accessibility of care to all patients.
- Contributes to care team pre-planning (aka Team Huddle) with reminder calls, and updating registration info prior to each scheduled appointment, or rescheduling as deemed appropriate
- Participates in continuous quality improvement activities and patient-centered medical home team meetings and trainings, and is receptive to accepting other job duties as assigned and as delegated
- Assists in responding to and resolving patient complaints as needed
- Works collaboratively with other departmental personnel to process and complete the patient encounter and collect amounts due in accordance with established procedures.
- Makes appointments and registers patients
- Using proper phone etiquette, answers all incoming calls by 3rd ring. Responds to calls appropriately, including message taking and distribution.
- Enters, reviews, and makes necessary changes to all patient registration information in the practice management system in accordance with established procedures.
- Researches answers and responds to patient’s questions/correspondence about their account in a timely and professional manner, respecting patient confidentiality.
- Opens and closes the clinic according to IBCC procedures.
- Maintains a neat and organized work area with appropriate labeling of files as needed.
Knowledge: Customer service, basic medical front office practices, basic computer operations,
Skills: Aptitude for skilled personal communication is mandatory. Strong written and verbal skills, typing 35+ wpm. Heavy phone experience.
Ability to: Work well with people; communicate effectively and respectfully in English and/or other languages; operate computers and other modern office equipment; work in a busy environment; multi-task, be flexible to accommodate to travel and changes in daily and hourly schedules
Education/Experience Requirements: High school diploma or GED; Bilingual English/Spanish encouraged but not mandatory; 2-3 years’ experience in medical/data processing field preferred; Certificated through medical front office training program preferred. Typing certificate preferred >35 wpm.
Must maintain annual CPR certification and TB clearance.
Company Paid Employee Health Insurance:
o Life insurance $25,000.00
Paid days off
• 2 weeks vacation first year
• 2 weeks sick days
• 10 Paid holidays
• Paid employee birthday