Patient Care Contract Specialist, Tft
2 weeks ago
**Job Description**:
**_ CARE AND BE CARED FOR - THIS IS YOUR HOME_**
Reporting to the Manager, Patient Services Contracts, this position is responsible for the development, delivery, and maintenance of all Family Managed Home Care (FMHC) agreements. This position tracks and manages on-going FMHC contractual issues, requirements, responds to questions from patients and/or Substitute Decision Makers (SDMs), Finance, and Home & Community Care Support Services staff. Liaises with Home and Community Care Support Services and Finance to onboard new patients/SDMs, and transitions patients/SDMs off the program as required.
This position is also responsible to enhance a culture of quality improvement, performance effectiveness and accountability by providing analysis, interpretation, reporting and administration of all patient services contracts in alignment with the established performance management framework.
What will you do?
- Provides guidance to all levels of staff and service providers related to service allocation, contract requirements, policies and guidelines related to service delivery.
- Monitors quality and performance standards of Service Providers by continuous analysis of service data from relevant areas/departments within Home & Community Care Support Services.
- Responsible for regular updating and reporting of contracts data to Ontario Health and regional partners as required.
- Identifies, analyzes and documents statistical trends and/or non-compliance of contract management issues and communicates to the Manager, Patient Services Contracts, as appropriate.
- Oversees the data collection and ongoing monitoring of market share and service volumes for each Service Provider, including adjusting service allocation processes, and identify and coordinate with the Finance Team any rate adjustments resulting from high/low volumes.
- Prepares monthly/quarterly/annual summaries of Service Provider performance reports and discusses any concerns that have been identified.
- Notifies Manager, Patient Services Contracts when Service Provider performance present a high level of risk or Service Provider is failing to achieve the necessary level of performance improvement.
- Compiles background information and data analysis to support QIN (Quality Improvement Notice) documents. Maintain QIN documents re Action Plan updates and tracking revisions to QIN throughout the performance management process.
- Prepares data and background information to support Service Provider audits or contract compliance investigations.
- Responsible for the continued maintenance of all contract-related documentation and databases to ensure that required insurance, WSIB, financial statements, accreditation, prequalification, etc. are current and updated upon expiry.
- Support the development, delivery, and amendment of all Patient Services contracts.
- Maintain and update Service Provider portal to ensure that information is current, relevant and easily accessible. Provides in-service training for Service Providers on portal administration.
- Ensure Service Provider contact information is current and posted on Sharepoint.
- Work closely with the Finance Team regarding any billing issues affecting Service Providers to determine root cause and develop improvement initiatives to mitigate billing errors.
- Develop and maintain positive working relationships with Home & Community Care Support Services staff to develop and implement new processes to improve performance monitoring.
- Develop and maintain positive working relationships with Service Providers to ensure collaboration and fulsome engagement in the provision of quality, safe, and efficient services to patients.
- Maintain control over all contract management through process documentation, measurement, evaluation and improvement.
- Provide expert analysis on Service Provider performance to inform process improvement initiatives.
- Actively participate in process improvement focus groups and committees to improve internal and external (Service Provider) processes that will facilitate safe and efficient service provision.
**Family Managed Home Care (FMHC)**
- During the onboarding process, meets with FMHC patient/SDM to review FMHC agreement requirements, as well as roles and responsibilities as required.
- Obtains applicable approvals, prepares agreements, issues to patients/SDMs for signatures, and ensure all supporting documents (i.e. banking, insurance, etc.) are received and accurate.
- Tracks and manages on-going contractual issues, requirements, responds to questions from patient/SDM, Finance, and Home & Community Care Support Services staff.
- Review and issues updated care plans and budgets to patient/SDM, based on Care Coordinator’s reassessment.
- Manages other FMHC program-related requirements/projects as required (i.e. contract amendments, provincial rate increases, etc.).
- Works with FMHC Team to analyze program trends, waitlist strategies, efficiencies of proce
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