Patient Engagement Specialist I
About The Position
We are currently seeking a highly motivated Patient Engagement Specialist I in the Orange County area. This role will report to the Manager – Quality Care Improvement and enable us to continue to scale in the healthcare industry. As a Patient Engagement Specialist, you’ll focus on outreach to members, assist with scheduling, and retrieve records through portals, EMRs, or on-site provider visits to support gap closures. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team
Requirements
- Minimum of Associate's degree, Bachelor’s degree or equivalent years of experience
- Experience using Microsoft applications such as Word, Excel and Outlook
- Proficiency in electronic scheduling
- At least one (1) year of HEDIS related experience
- Must have Driver’s License, reliable transportation and be willing to travel between office locations as needed
- Ability to prioritize and effectively multi-task
- Ability to quickly adapt to various situations
- Excellent organizational skills and strong attention to detail
- Effective and professional communication skills
- Self-driven, quick learner, patient, must be able to work with people of different personalities
Nice To Haves
- Fluent in Spanish and/or Chinese (Cantonese/Mandarin)
- 1-3 years of IPA/MSO/HP or general healthcare experience
- Excellent analytical critical reasoning and interpersonal communication skill
- Ability to work in a fast-paced environment
- Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information
Responsibilities
- Conduct outreach calls to inform patients of recommended services for HEDIS measure gap closure in a courteous and engaging manner
- Requests and gathers necessary medical records as needed.
- Effectively organize projects and tasks based on priority to help meet expectations and deadlines of projects
- Collaborates with the health plan, PCP, and health care team to ensure timely communication of member's clinical information.
- Generates letters and faxes to PCPs, Specialists, patients, and other health care team members.
- Analytical problem solving with the ability to understand the overall picture
- Coordinate care for patients as appropriate such as scheduling appointments, creating authorizations to facilitate/expedite patient’s requests based on provider’s orders.
- Maintain strict confidentiality of business discussions
- Travel to various offices as designated
- Ad-hoc projects as assigned by the manager/supervisor
- May be required to work overtime to meet tight deadlines
- Comply with department policy and procedures
- Collect and collate appropriate data from IPA network providers for HEDIS measures
- Collect medical records, conduct reviews and ensure accuracy of documentation for reporting
- Collect, summarize and trend provider performance data to include provider education
- Participate in ongoing discussions concerning data collections and analysis for HEDIS
- Assist in planning and implementation of projects to improve delivery of services and quality of care
- Understand the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards and HIPAA
- Generate and maintain accurate weekly/monthly/quarterly report of activities
- Attend to health plans, provider, and interdepartmental calls
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
Number of Employees
1,001-5,000 employees
