High Value Clinical Consultant
Job ID: R0043267 | Advance Practice Provider | Full Time | Charlottesville, VA
The High Value Care Consultant will support Practice Innovation efforts to redesign care to positively impact quality of care delivered, enhance the experience of care for clinicians and patients, and optimize return on value-based opportunities. This position will serve as a consultant to ambulatory settings, providing direct clinical support to achieve desired outcomes on priorities and projects with strategic importance to Practice Innovation (ex: medical annual visits), as well as subject matter expertise on administrative and operational functions (ex: selecting relevant measures, workflow build feedback). Reporting to the Senior Director of Practice Innovation but working across the organization, this position requires a high level of clinical judgment, interpersonal skills, creativity, organization, and independent priority-setting.

Administrative Responsibilities:
  • Serves as a liaison, advocate, and educator for assigned practice locations regarding improvement opportunities and Practice Innovation priorities.
  • Serves as a resource for others, providing subject matter expertise and leadership for various components in the development of operational systems to enhance the value of care provided, including identifying relevant performance measures and establishing appropriate KPIs, goals and objectives, and policies; developing meaningful audience-specific communications; evaluating potential risks and outcomes for various initiatives; etc.
  • Uses advanced knowledge of clinical delivery systems to coordinate, maintain, and provide meaningful information to physician leadership, management, and teams to evaluate clinical practice, process, and High Value outcomes.
  • Participates in implementation and monitoring of quality improvement activities.
  • Participates in professional development activities to keep current with healthcare trends and practices, and keeps Senior Director informed of trends to facilitate proactive organizational adaptation.
  • Establishes high-functioning relationships with provider care teams that foster support of the organization's mission, vision, and financial and strategic plans.
  • Represents Practice Innovation on various UPG and UVA committees and participates in meetings, as requested.
  • Assists with retrospective chart reviews, using best practices from CDI and clinical decision-making to identify potential improvements in charting, reimbursements, and appropriateness of patient care.
  • Presentation experience and/or skills to present meaningful information/data to a diverse group of roles a plus.
  • Collaborates with clinical staff, project management, and development teams to design and develop clinical documentation based on workflow processes, staffing models, regulatory standards, technological solutions (ex: team care, chronic care management), etc.
  • Recommends innovative ideas, processes, and/or procedures for enhancements, additions, and modifications to improve existing systems of care.
  • Other duties as assigned.

Clinical Responsibilities:
  • Performance of billable care services within scope of practice that support clinics in achieving optimal performance on initiatives involving Practice Innovation priorities, such as medical annual wellness visits and chronic care management.
  • Support for clinical tasks as an embedded member of the care team for up to three days a week and/or three practice locations within a reasonable geography (locations and schedule to be discussed with incumbent), as well as via virtual methods.
  • Works in conjunction with the medical director, administrative management, and nursing staff to facilitate patient care and management throughout the healthcare system.
  • Exercises independent judgment in the assessment, diagnosis, and initiation of medical processes and procedures commensurate with training and experience, as credentialed by UVA Health System.
  • Performs and documents comprehensive health histories and physical assessments, to include initiation of CPR or other appropriate emergency therapy as needed.
  • Formulates diagnoses, identifies problems and health risk profiles, documents, and clearly communicates with other members of the healthcare team.
  • Performs, orders, and interprets diagnostic studies, such as X-rays and laboratory tests, in consultation with peers and colleagues.
  • Performs procedures within scope of practice and UVA Health System credentialing and privileges.
  • Prepares and attends to all reports, claims, and correspondence necessary or appropriate to the performance of professional services.
  • Follows policies and procedures, including those of UPG, UVA Medical Center, CMS, and other contracted payers with which the entity may contract.
  • Accurately assigns Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes.
  • Orders medications, treatments, and therapies in accordance with Virginia prescriptive regulations.
  • Requests consultation and initiates referrals to other healthcare providers, including specialists when and if needed.
  • Evaluates and analyzes patient responses to the disease process and/or therapeutic, diagnostic interventions.
  • Provides information, education, and support to patients/families regarding disease processes and treatment plans (diagnostic procedures, medications, and treatments), thus facilitating communication between patients/families and the healthcare team.
  • Participates in on-call responsibilities as appropriate and as determined by department or unit.
  • Manages patients in accordance with established UVA Medical Center and UVA UPG policies and procedures.

MINIMUM REQUIREMENTS

Education:
  • Graduate of an accredited graduate school of nursing or physician assistant program with a master's degree, or graduate of accredited medical school with degree of Doctor of Medicine (MD) or Doctor of Osteopathy (DO). Completion of accredited residency in chosen specialty.

Experience:
  • Five or more years of clinical practice.
  • Experience in healthcare quality data analytics, HEDIS, managed care quality, utilization review, or case management.
  • Experience with Epic preferred.

Licensure:
  • License or license eligibility as an advanced practice provider (nurse practitioner, physician assistant, certified registered nurse anesthetist, and certified nurse midwife) as set forth by the state of Virginia. If nurse practitioner, license to practice as a registered nurse in the Commonwealth of Virginia is required; or board certification in specialty (if newly graduated from residency, must be obtained within 2 years of graduation) must be kept current. Unrestricted license to practice within the Commonwealth of Virginia. Current DEA certificate without restriction.
  • Must demonstrate and maintain all applicable credentialing and licensing requirements of the UVA Medical Center, Virginia Board of Medicine or Nursing, and appropriate certifying bodies.
  • Current Basic Life Support (BLS) required.
  • Current Pediatric Advanced Life Support (PALS/NRP) or Advanced Cardiac Life Support (ACLS), as required specific to position.

PHYSICAL DEMANDS
Job requires standing for prolonged periods, frequently bending/stooping, and reaching (overhead, extensive, and repetitive). Repetitive motion: computer keyboard. Proficient communicative, auditory, and visual skills. Attention to detail and ability to write legibly. Ability to lift/push/pull 50-100 lbs. May be exposed to noise, radiation, radioactive materials, blood/body fluids, and infectious disease.



COVID Vaccination Requirement and Guidelines

 

Please visit the UVA COVID-19 Job Requirements and Guidelines webpage prior to applying for current information regarding vaccination requirements and guidelines for employment at UVA.

 

 

 


Charlottesville, VA
Charlottesville, VA 22903
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Since 1979, UPG has been the clinical partnership group managing, growing and providing direct patient care for all UVA entities. This strategic partnership allows UVA to expand on education, technology, diagnostics, resources and facilities while the teams at UPG can focus on managing and delivering high-quality, multi-specialty care.

The expansive network of UPG providers and clinical support teams work together to deliver world-renowned care to patients at UVA Medical Center in Charlottesville and in 24 primary and specialty care clinics located throughout central and northern Virginia.

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