Provider Operations Coordinator - Lincoln
About The Position
The Provider Operations Coordinator (POC) manages operational support initiatives and special projects, focusing on HEDIS quality gap closures, Risk Adjustment activities, and provider engagement. The role involves daily problem-solving, tracking, and coordination across departments as requirements change. The coordinator oversees assigned affiliate groups and supports clinics in achieving their goals, including outreach to patients for education and engagement related to preventive screenings, medication adherence, and follow-up with primary care providers. Depending on experience and education, the position may involve direct patient interaction to complete quality gap closure tasks. The position is based in the Lincoln, Nebraska area and requires travel throughout the region. It is 100% on-site, with the opportunity to work remotely on Fridays when not needed in the field or office. Work hours are Monday through Friday, either 7:30 a.m.–4:30 p.m. or 8:00 a.m.–5:00 p.m. The role may require work from multiple provider offices for up to 90% of the work schedule.
Requirements
- High school diploma or GED.
- At least 2 years of experience in healthcare-related fields.
- Experience with Microsoft Word, Excel, PowerPoint, Outlook, and general office equipment such as copiers and fax machines.
- Experience with Electronic Health Records.
- Knowledge of medical terminology.
- Excellent interpersonal, rapport-building, trust-building, and communication skills with patients, providers, and internal and external stakeholders.
- Strong organizational and time-management skills.
- Strong analytical, critical-thinking, and problem-solving skills.
- Ability to present information and obtain buy-in on recommendations.
- Ability to work in a fast-paced environment and prioritize tasks based on importance.
- Ability to work independently or as part of a team.
- Dedication to maintaining the confidentiality of patient records.
- Knowledge of vital signs and other clinical skills related to direct patient care for quality gap closure.
- Availability to travel within the assigned region and work from multiple provider offices up to 90% of the work schedule.
- Valid driver's license, safe driving record, and reliable transportation.
Nice To Haves
- Associate degree in a related field or equivalent experience.
- Clinical healthcare-related experience, managed care experience, or health plan experience.
- Medical Assistant Certification or experience as a Pharmacy Technician, Radiology Technician, Lab Technician, or similar.
- Experience with data mining.
- Experience with CPT II codes.
- Current CPR certification.
Responsibilities
- Build and maintain effective relationships with assigned affiliate groups to achieve goals and key initiatives, serving as a liaison between affiliate groups and P3 local, regional, and national departments.
- Advise and support affiliate practices on quality (HEDIS/HOS) gaps and conditional documentation through outreach, chart data mining and audits, claims surveillance, quality events, and education for practice employees; review collected data to confirm gaps in care are captured.
- Work with affiliate practices to prioritize patient outreach and assist with outreach and scheduling new and established patients, identifying appointment times that meet patient needs and availability.
- Partner with assigned groups and other P3 departments to coordinate care for high- and rising-risk patients across healthcare services, including hospital discharge, hospice, MRA, care management, referrals, and quality.
- Assist with CSR/IDT/JOC meeting preparation and participate in meetings as requested.
- Enter data and maintain appropriate documentation and tracking for quality initiatives.
- Educate patients and affiliates about scheduled or performed preventive screenings and the reasons for them.
- Depending on education and experience, conduct in-home HEDIS gap closure for select measures, such as blood pressure checks, diabetic eye exams, point-of-care hemoglobin A1c testing, and distribution of colorectal screening kits.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
