Prevention Health Specialist - Must be Mississippi Based
About The Position
TrueCare is a Mississippi non-profit, provider-sponsored health plan formed by a coalition of Mississippi hospitals and health systems throughout the state and supported by CareSource’s national leadership in quality and operational excellence. TrueCare offers locally based provider services through provider engagement representatives and customer care. Our sole mission is to improve the health of Mississippians by leveraging local physician experience to inform decision-making, aligning incentives, using data more effectively, and reducing friction between the delivery and financing of health care. By doing so, TrueCare will change the way health care is delivered in Mississippi.
Requirements
- Bachelor’s degree in business or health care field or equivalent years of relevant work experience is required
- Minimum of three (3) years of experience in healthcare, community health or related field is required
- Proficient in Microsoft Office including PowerPoint, Word and Excel
- Ability to communicate and interact with individuals at varying skill levels, educational and cultural backgrounds
- Familiarity of state and federal healthcare regulations and environment
- Data analysis and trending skills
- Strong presentation skills
- Excellent time management skills and ability to manage and meet workloads and deadlines
- Ability to work independently and within a team environment
- Critical listening and thinking skills
- Proper grammar usage and phone etiquette
- Customer service oriented
- Ability to be flexible
Nice To Haves
- Managed care organization experience is preferred
- Experience working with data and data analytics is preferred
Responsibilities
- Ensure that members eligible for Medicaid benefits receive outreach for informing, screening, tracking, diagnostic and treatment services available under the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit
- Responsible for execution, monitoring and reporting of Quality or Preventive Health Programs and strategies (i.e., School Based Health Centers, Telehealth), including supporting members with educational materials according to clinical best practice guidance
- Participate in quarterly market Quality Improvement and population health management workgroups
- Facilitate completion of the annual evaluation report for assigned market/product
- Attend telephonic Health Partner meetings with top providers; engage in population and rural provider strategy
- Telephonically contact eligible members and providers to discuss all preventive care needs, benefits and their current gaps in care
- Ensure that contractual/regulatory requirements for prevention services are met
- Collaborate with enterprise quality for all prevention services, analysis of data and reporting
- Be fully versed in individual state clinical/programmatic contract management requirements
- Collaborate closely with members’ assigned case managers to coordinate care and programs
- Prepare weekly, monthly, quarterly and annual reports of outreach activities
- Perform any other job duties as assigned
Benefits
- In addition to base compensation, you may qualify for a bonus tied to company and individual performance.
- We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
