Population Health Assistant

Advocate Health and Hospitals Corporation • Charlotte, NC

20h • Remote

About The Position

The Population Health Assistant plays a crucial role in coordinating the Care Coordination process, managing patient outreach, and supporting various administrative and analytical functions within the Value Enablement Services department. This remote position involves intake of new and established cases, facilitating medical reviews, verifying eligibility, assessing clinical and non-clinical data, and triaging cases to appropriate resources. The role also includes initiating and monitoring care coordination plans, maintaining resource libraries, conducting medical literature searches, and coordinating the implementation of new employer groups and care gap outreach. Additionally, the assistant will generate reports, track data, manage department materials, and perform administrative duties such as screening calls, managing mail, and ordering supplies.

Requirements

• High School Graduate.
• Typically requires 5 years of experience in population health management, utilization management, claims, health insurance processing, clinical or care management/quality environment.
• Proficiency in the use of ICD-10, CPT and HCPCS coding preferred.
• Knowledge of medical terminology.
• Ability to manage data systemically.
• Demonstrates organizational ability and attention to detail and accuracy.
• Advanced skills and knowledge in the use of Microsoft Office (Excel, PowerPoint and Word), Internet explorer and similar products.
• Excellent organizational, interpersonal, and communication skills (written and verbal) with the ability to effectively communicate with a variety of individuals.
• Exercises independent judgment and demonstrate excellent problem-solving skills while able to still work well within a team.
• Ability to demonstrate self-direction in prioritizing and accomplishing job responsibilities.
• Ability to maintain a high degree of confidentiality.

Nice To Haves

• Proficiency in the use of ICD-10, CPT and HCPCS coding.

Responsibilities

• Coordinates intake of cases on new and established assignments to expedite the Care Coordination process by facilitating the medical review process, verifying health plan eligibility, obtaining and assessing preliminary clinical and non-clinical data or needed additional data, determining appropriate case type, and triaging to the appropriate resource.
• Initiates and advances the Care Coordination plan, monitors status and advises regarding requirements, process and status.
• Researches, organizes and maintains the team's library of resources, guidelines and policies.
• Performs medical literature review searches to support the department.
• Facilitates implementation of new employer groups in collaboration with Onsite Nurse and sales staff.
• Insures adequate onboarding materials are available and interim reporting tools and processes are in place.
• Coordinates implementation of care gap outreach.
• Utilizes established criteria to generate lists of members requiring intervention and to process reminders according to established protocols.
• Verifies list accuracy and documentation of interventions.
• Assists in development and training of new employee department members in areas such as information system programs, individual health plans, and policies and procedures.
• Trains and educates provider office staff in referral/authorization process and procedures, contracts, standards, benefit plan limitations, and resource/contact liaisons.
• Develops and generates reports, as well as gathers, compiles and summarizes data for reporting and analysis by staff, management and external partners.
• Assists in monitoring, tracking and analyzing data.
• Coordinates development, ordering and stocking of materials to support Population Health activities.
• Initiates design based on branding guidelines and business needs.
• Oversees and/or maintains department files, binders, records, logs, etc.
• Identifies need of additional record keeping and establishes same.
• Performs a variety of routine and moderately complex administrative duties such as screening incoming telephone calls; open, sort and route incoming mail and faxes; typing letters, memos and reports; monitoring office equipment; purchasing/ordering of equipment or supplies.

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED