ESSENTIAL FUNCTIONS    
•    Provides oversight of the disease registry database including:
a)    Assuring database is maintained and kept up to date.
b)    Creating patient, physician, and clinic level quality performance reports.
•    Provides proactive outreach to patients including:
a)    Identifying patients overdue for visits, labs, or referrals and arranging for follow-up services as appropriate.
b)    Identifying patients not meeting clinical goals, such as BP control or glucose control, and arranging for follow-up services by protocol or as appropriate. 
•    Assists with Coordination of Care across the care continuum including partnering with the RN Health Coach by making needed appointments or referrals such as to community resources, specialty providers, or disease specific educators. 
•    Conducts data abstraction from various electronic systems
•    Utilizes software to review work queues/patient lists for continuity of care and patient outreach activities
•    Participates in QI activities:
a)    Participates in Clinic and hospital quality and performance improvement initiatives
b)    Meets on a regular basis with the hospital Care Management Team for information sharing and continuing education activities.
c)    Gathers data for the Group Practice Reporting Systems (GPRO) Medicare quality indicators

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES
•    CMA or LPN preferred.
•    Clinic/Physician office experience preferred. 
•    Enjoys working with people, assisting in addressing their needs, and being a partner in     achieving optimal health
•    Demonstrates competent computer skills including web-based navigation, email, and MS Office
•    Demonstrates familiarity with local demographics, geography, and community
•    Knowledge of and practical use of good business English, spelling, arithmetic, practices, and the ability to communicate effectively using written and verbal skills.
•    Certification as Healthcare Coach or obtained within one year of hire.
•    Basic Life Support (BLS) for the Healthcare Provider certified or obtained by the end of the orientation period (approximately six (6) weeks).
•    Proof of completion of Mandatory Reporter training (Adult and Children) within three (3) months of hire.

Technical Skills:
Ability to operate essential equipment and perform essential procedures in nursing department.  Demonstrates knowledge, abilities and skills required to perform a wide variety of nursing functions.  Mathematical ability necessary to compute drug dosages accurately.  Annual completion of unit specific competencies.

PC Competencies:
The incumbent must demonstrate an understanding and working knowledge of the Windows environment as well as ability to access and use information in meaningful ways.  The incumbent must have the ability to access, manipulate, organize, and relay information in meaningful ways using email, word processing, excel, and power point.   CPSI knowledge and resource.

Behavioral Competencies: 
Support Dallas County Hospital’s vision and mission; maintain confidentiality of all work information.
Demonstrates an ability to function successfully in a team environment; exhibit courteous, compassionate, and respectful treatment of internal and external customers; display a positive attitude and flexibility in changing situations; participate in identifying problems and suggesting solutions.  Understands and adheres to the Dallas County Hospital compliance policy.
DCH prohibits any retaliation, direct or indirect, against an employee who, in good faith, seeks help or reports known or suspected violations of the Code or related Policies.

Decision Making Latitude: 
Freedom to determine how to best accomplish functions within established procedures and protocols and confers with the Clinic Director.

https://www.dallascohospital.org/careers/job-application