Provider Referral Analyst

Administration

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Description

Duties and Responsibilities:
  • Act as a liaison between providers and the provider practices including spending time on-site at each clinic interacting with providers concerning their performance including reviewing quality data and referral metrics.
  • Possess an in-depth knowledge, understanding and application of NCQA standards for PCP and PCSP patient throughput to be a resource for providers.
  • Analyze referral data to determine trends. Review incoming and outgoing referrals with providers for completeness to close the loop for the best patient experience and outcomes.
  • Deliver insights to drive quality outcomes cost-effectively to improve efficiency to providers and others through data exchange. Assists and/or recommends ways to improve communications and to provide feedback to both internal and external referring physicians.
  • Creates and presents complex ad hoc data analysis and reports for providers.
  • Represents Clinic quality team in collaboration with other internal teams for continual process improvement initiatives to simplify and enhance the customer experience. 
  • Monitor process performance metrics to ensure that improvements are maintained over time.
  • Prepare reports that establish recommended interventions and document their impact on patient care delivery.
  • Regularly present findings and recommendations to management.



Preferred Skills and Qualifications:
  • Associate’s or Bachelor's degree in business, healthcare, or a related field
  • Minimum 2-3 years of experience in data collection, process improvement, quality assurance, or a similar role.
  • Excellent analytical and problem-solving skills.
  • Strong communication, presentation and interpersonal skills and the ability to work effectively with a wide range of individuals and constituencies in a diverse community.
  • Ability to interpret and analyze data and provide insight to providers on improvement initiatives. 
  • Ability to gather data, compile information, and prepare complex reports.
Certifications and Licenses:

Obtain certification as a PCMH content expert within 6 months of hire


We are an E-Verify employer.

For more information, please click on the following links:
E-Verify Participation Poster: English | Spanish
E-Verify Right to Work Poster: English | Spanish

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