Panel Coordinator

Hillsboro Medical Center•Hillsboro, OR

13d•$24 - $33

About The Position

The Panel Coordinator role provides complex and diversified coordination, analytical, and administrative support through a team-based approach to patient care within their primary care medical provider’s office. This highly patient-centered delivery of care is vital to the implementation of the innovative Patient Centered Medical Home model at the primary care practices. This continuous learning approach contributes significantly to proactively gathering data, analyzing current processes (i.e. developing "intelligence"), identifying steps for improvement, and developing procedures, forms and educational materials that translates the "intelligence" into language best understood by all team members - in the interest of optimal patient involvement and team performance. Works closely with the Medical Home Specialist(s) to support the continuing development and changing requirements of the program and need to keep an eye on the big picture of what is going on in their team at all times, to set up the clinical team to be able to "work at the top of their scope of practice", and are trained to provide backup as appropriate for other members of the team who may be absent.

Requirements

High school graduate or GED.
A copy of your highest academic diploma or transcript required upon hire.
One (1) year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and obtaining managed care authorizations.
Previous use of EPIC, Solutions, Business Objects, Crystal Reports and basic computer skills including word processing, Windows applications, on-line scheduling, and a preference for data-base skills.
Knowledge of medical terminology, CPT and ICD-10 CM coding methodology.
Current American Heart Association provider- BLS certification upon hire or within 90 days of hire.
Demonstrates professional appearance and personal conduct for the employee's particular job.
Excellent customer service and listening skills and use of effective communication skills taking into consideration body language, filters, listening, paraphrasing, questions with customers of diverse ethnic and cultural backgrounds.
Excellent verbal and written communications skills. Strong customer service orientation. Demonstrated effectiveness in confrontational customer interactions.
Demonstrates effective organization skills and ability to multitask with frequent interruptions.
Demonstrates knowledge of managed care insurance plan requirements. Understanding of age specific preventive health maintenance indicators and disease specific standards of care for those prevalent in underserved family medicine population.
Have knowledge of barriers to care such as language, transportation, ability to cope and self-advocate and bring these to the attention of the care team
Have knowledge of different health plan requirements for pre-authorization of treatments and coverage limits.
Able to apply and share knowledge of community health and social service resources, including the systematic navigation and coordination of care outside of the Primary Care medical home, to meet patient needs.
Practices confidentiality regarding staff, department and organizational issues.
Demonstrates confidentiality in dealing with patients, patient families and co-workers.
Functions as a cooperative, flexible team member in a positive manner utilizing good communication techniques.
Independently and proactively identify patients in the practice by running panel reports for specific diagnosis and preventive care needs.
Serve as an effective communication link between patient and clinic staff by gathering information from patients.
Looks for ways to improve customer service.
Consistently provides leadership to staff and has ability to effectively manage conflict and concerns through effective communication and problem solving techniques
Demonstrates personal computer skills including working knowledge of Word and Excel programs.

Nice To Haves

Associate degree or Bachelor degree in Business, or Health Care related field.
Prior experience working in a Patient-Centered Medical Home.
Certification from one of the following: o Certified Medical Assistant (CMA) from American Association of Medical Assistants (AAMA) or o Registered Medical Assist (RMA) by American Medical Technologies (AMT) or o Certified Clinical Medical Assistant (CCMA) by the National Healthcare Association (NHA) or o Nationally Certified Medical Assistant (NCMA) by National Center for Competency Testing (NCCT) highly preferred.
Bilingual in Spanish and English.

Responsibilities

Evaluate and analyze patient records, based on Primary Care patient standards, to identify patients who need: preventive services, diagnostics, and follow up.
Coordinate services for all patients who are part of the assigned panel, focusing on gaps in care and clinic identified strategies for specified populations including those with serious, complex or chronic health problems or with psychosocial issues.
Communicates with patient directly to discuss preventative care needs and refers patients with medical concerns to appropriate clinical staff.
Track progress for assigned clinic or populations on performance of key clinical quality metrics.
Review provider schedules and patient charts to assist the care team in coordinating care for visits and identifying preventive healthcare needs.
Schedule patients for preventive care needs and follow up to ensure completion of services.
Work with the Medical Home team on developing standards, implementation, and maintenance of programs in chronic disease management for patients.
Help to optimize revenue for the practice, especially regarding pay-for-performance reimbursements and grant related revenue.
Appropriately develops and provides on-going panel evaluation for specific diagnosis and preventive care needs.
Communicates with Health Plan Coordinator as needed regarding the need for pre-certifications on procedures, orders or medication with insurance companies.
Reviews and takes action on items in financial work queues.
Maintains appropriate notations and copies of documents in patient charts.
Updates demographic records for patients, entering all information from patients directly into computer in a concise and professional manner.
Responds to correspondence as appropriate, by phone or in writing.
Maintains an organized work area.
Maintains appropriate levels of office supplies required to perform tasks.
Provides patient education about health plan issues as appropriate.
Runs EHR reports for orders of treatment plans, referrals and procedures as needed.
Works with patients to find co-pay and drug assistance as needed.
Prepares and sends medical information to third parties and referral physicians as needed.
Attends and actively participates in staff meetings.
Communicates supply needs in a timely manner to the ordering person.
Attends insurance workshops and reads insurance updates.
Completes all mandatory education and licensure requirements to meet state, professional and regulatory requirements.