ECM Operations Support Specialist

Organizational Description

The Community Health Center Network (CHCN) is a partnership between eight health service organizations in Alameda County, whose mission is to provide a comprehensive range of professional health care in a manner respectful of the community values and traditions.  CHCN is a nonprofit corporation, serving as an agent for its member health service organizations.  

Position Title:            ECM Operations Support Specialist

Department:              Care Neighborhood Enhanced Care Management

Reports To:               Senior Director of Care Management        

Classification:           Non-Exempt

Status:                        Part-Time Temporary

POSITION SUMMARY

The Care Neighborhood (CN) Enhanced Care Management (ECM) Operations Support has primary responsibility for the operations of CN ECM on a temporary basis while the ECM Operations Supervisor is out on leave, especially regarding, but not limited to, data and reporting, clinical documentation, quality assurance and quality improvement, as well as Community Health Worker (CHW) support. This team member will lead the interface with the CHCN Data and Analytics team, and work to improve documentation and reporting processes. They will also interface with health plan partners, as well as community-based organizations. ECM Operations Support will take the lead on optimizing and translating requirements for the program into workflows and documentation disseminate these changes to the CHWs and follow up with quality assurance to assure that documentation is appropriate and robust.   

ESSENTIAL POSITION FUNCTIONS

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain and/or be interpreted as a comprehensive inventory of all duties, tasks and responsibilities. Employees may perform other duties as assigned.

·        Partner with CHCN Data and Analytics team to ensure accurate and timely reporting. 

·        Provide operational support during team meetings. 

·        Troubleshoot CHW issues related to EPIC/Compass Rose and Tableau workflows. 

·        Collaborate with internal and external teams (IT, OCHIN, Data Analytics) to design, implement, and evaluate care management programs. 

·        Develop and implement effective practices, protocols, and workflows for ECM. 

·        Lead implementation of care management tools to improve quality, patient outcomes, and resource utilization. 

·        Manage performance improvement projects and transformation initiatives for ECM populations. 

·        Ensure standardization and optimization of workflows across models of care. 

·        Oversee design and evaluation of IT solutions supporting documentation and monitoring.

·        Support CHWs in maintaining robust documentation that reflects services provided.  

·        Work with Senior Director to meet clinical and productivity metrics. 

·        Manage ECM billing and reimbursement processes with CHCN clinics. 

·        Serve as liaison between Data Analytics, Accounts Payable, Quality Improvement, and IT Systems to ensure operational effectiveness. 

·        Apply Motivational Interviewing, person-centered, and trauma-informed care principles. 

·        Exercise sound judgment in prioritizing tasks and seeking guidance when needed. 

·        Maintain compliance with departmental documentation standards and CHCN policies. 

·        Foster a positive work environment and teamwork across departments.

HIPAA Designated Access

“For the purposes of the job duties of this position, the person in this position requires access only to the following HIPAA protected information data sets.”    

SUPERVISORY RESPONSIBILITIES

Supervises the ECM Operations Specialist

MINIMUM QUALIFICATIONS

Competencies  

·       Competent leadership and administrative skills.

·       Good communication and customer relations’ skills; ability to work well with a team and independently.

·       Case Management experience, understanding and knowledge of healthcare benefits associated with various business lines (Medi-Cal, Medicare, and Commercial).

·       Ability to work independently in most instances, requiring limited supervision.

·       Proficiency in computer operations, navigational skills and comfortable with Internet-based applications. 

·       Sound decision-making skills including problem solving, critical thinking, and good clinical judgment for clinical and non-clinical issues.

·       Professional demeanor.

Essential Requirements

·       BA degree or higher, with at least 3 years of experience in case management.  

·       Excellent communication, organizational and time management skills with the ability to meet tight timeframes. 

·       Strong understanding of the managed care environment.

·       Ability to work effectively and collaboratively with a variety of customers including CHCN health center staff, internal CHCN colleagues, health plans, patients and providers.

·       Be creative and mature with a “can do”, proactive attitude and an ability to continuously “scan” the environment, identifying and taking advantage of opportunities for improvement. 

·       Commitment to working directly with low-income communities with diverse backgrounds, in a helpful, supportive manner.

·       Strong computer literacy and familiarity with electronic medical record and supporting applications, such as EPIC and Tableau.

·       In-depth knowledge of and proficiency in case management, health issues, and the health care system.

·       Manages complex and sometimes contradictory information to effectively solve problems.

·       Flexible and adaptable to a rapidly changing program that continues to shift gears at the State and local level.

·       Understands data and analytics relevant to case management and monitoring and reporting of productivity to meet required outcomes.

·       Ability to learn quickly and retain complex information.

·       Travel to work assignments - must have a reliable mode of transportation that meets the needs of an urgent response environment.

General CHCN roles

·       Fosters an environment that promotes trust and cooperation among clients, clinical care team, and CHCN staff.

·       Enforces policies and procedures, including maintenance of client confidentiality, to ensure that the principles of CHCN are implemented.

·       Accountable for participating in decision-making processes and understanding the outcome(s).

·       Understands the values and principles of CHCN and applies them in work responsibilities.

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.

While performing the duties of this job, the employee is regularly required to sit and use hands to manipulate, handle, or feel. The employee is frequently required to talk or hear. The employee is frequently required to stand; walk; reach with hands and arms and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds.  Specific vision abilities required by this job include close vision and ability to adjust focus.

WORKING CONDITIONS AND ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly exposed to both an inside/outside environment.

The Community Health Center Network is an Equal Opportunity Employer.