Health Operations Analyst and Access Manager

POSITION SUMMARY:

Responsible for financial and data analysis of APLA Health clinical operations, managing patient panel assignments, and developing and tracking reports on key metrics and conducting staff training.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Ensures each patient is assigned a Primary Care Provider
• Resolves unassigned patients by reviewing appointment history to determine appropriate assignment based on PCP availability
• Monitors influx of new patients into provider panels and analyzes provider capacity (panel fullness) to absorb new patients; reviews issues with medical director and reassigns as appropriate
• Reporting:
  • Develops monthly panel report and reviews PCP assignments. The monthly panel report consists of all patients seen in specified month, assigned PCP, treating provider (continuity), retention and PCP Change
  • Determines continuity percentages for each provider against CHC goals.
  • Ensure continuity target goals are being met. If not, develops a performance improvement plan in collaboration with the Chief Clinical Operations Officer and Chief Medical Officer
  • Develops and generates operational reports such as panel fullness, urgent/same day appointment availability, third next available, provider productivity reports, budgeted visits to actual visits, unlocked charts, etc.
• In collaboration with the Chief Clinical Operations officer and the Chief Medical Officer, Manages PCP Change requests. Which could include
  • Patient-initiated PCP-change requests; facilitates discussion between and obtains approval from current assigned PCP and future PCP; makes the change in the practice management system
  • Provider-initiated PCP change requests. Facilitates discussion between current PCP and potential future PCPs; obtains agreement of acceptance by the new PCP. Makes the change in the practice management system.
• Tracks patient status changes including death, transfers to other care, and makes the change in the practice management system
• Assesses panel fullness against “right size” and discusses any needed adjustments with CMO
• Assess impact of requests for changes in part-time status
• Under the direction of the Chief Clinical Operations Officer and the Chief Medical Officer tracks impact and support medical and operational leaders in making decisions on cross coverage, temporary coverage, and movement of whole or partial panels tracks provider status changes (transfer, termination, sabbatical, medical leave, etc.) and:
  •  Evaluates impact on assigned panel of patients
  •  Reassigns panel to other clinic providers according to panel fullness
  •  Notifies affected patients of new PCP assignment
• Training:
  • Conducts empanelment 101 training for all staff (importance of empanelment, access, and continuity)
  • Conduct contact center training on scheduling with assigned PCP
  • Conduct PCP Change request training for contact center, front office/back-office staff
• Data oversight (and governance participation) of PCP data, clinical FTE data
• With Operations and Medical Leaders, create PCP Teams and care teams
• Manage and update PCP Care Teams (e.g., adjust teams if there are staff turnover issues)
• Managing weighting parameter

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

REQUIREMENTS:

Training and Experience:

• Bachelor’s degree required; Finance or Business major or other similar major required.
• Experience in data and financial analysis is required; preferably SQL.
• Experience in healthcare industry/operations, helpful.

Knowledge of:

• Healthcare operations
• Electronic health records and data reporting.
• Strong Microsoft Excel skills.

Ability to:

• Communicate effectively with providers, other staff, and outside vendors. Must be well-organized and detail-oriented.
• Strong analytical and written communication skills in order to prepare complete and accurate program reports and records. The ability to analyze and interpret data is required.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

SPECIAL REQUIREMENTS:

Must possess a valid California driver’s license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes. COVID vaccination is required and APLA Health will consider accommodations for medical- and religious-based reasons.

Equal Opportunity Employer: minority/female/transgender/disability/veteran.