Quality Specialist

Summit Health CityMD•Houston, TX

2d•Remote

About The Position

As a Quality Specialist, you will be responsible for performing outbound patient calls regarding our clinical programs, medication adherence, and closing gaps in care for value-based contracted patients with clinical quality needs. The role will partner closely with our quality, population health, and pharmacy teams to effectively deliver wrap-around care for our patients. The ideal candidate will have the ability to work in a fast-paced environment while using excellent communication skills to serve our patients. They must be proactive with a strong personal initiative, as well as highly organized and detail oriented.

Requirements

High school diploma or GED equivalent required
Certified Medical Assistant, Certified Pharmacy Technician, or equivalent experience in a healthcare setting required
Intermediate to advanced level keyboarding skills (at least 35 WPM, touch typing, formatting documents) required
Secure workspace at home, including desk and chair, with minimum background noise required
Candidate supplied home internet access required
Minimum internet download speed of 100mbps and upload speed of 10mbps required
Internet to be hard-wired with an ethernet cord required. Wi-Fi connection cannot be used.

Nice To Haves

1+ years of experience in a healthcare setting preferred
Prior experience using an Electronic Health Record (EHR) preferred
Previous call center or telephonic experience preferred
Experience with Medicare Advantage plans, insurance, and medication adherence preferred
Bilingual English/Spanish preferred

Responsibilities

Call patients to ensure they refill their chronic disease medications on time for diabetes, blood pressure, and cholesterol
Serve as liaison between patient, clinic, and pharmacy to minimize time missed between refills
Interpret patient medical history (medication list, office visit notes, etc.) and understand and properly communicate provider’s plan to patient
Navigate between different Electronic Medical Record (EMR) platforms to review patient medical information
Accurately and comprehensively document patient care activities in all applicable electronic records
Perform appropriate medication reconciliation by comparing how your patient is taking medication versus what is written in medical record and/or filled at the pharmacy
Request medication refills per clinic policy and protocol
Adequately assist patients with difficulties accessing medication due to cost or other barriers
Identify patients who need referrals to clinical pharmacist, retail pharmacy med sync program, retail pharmacy medication pack program, care management, clinician, and/or Village at Home
Timely follow up and persistent outreach to patients, providers, and pharmacies to ensure medications are picked up and taken as directed
Connect with patients before and after their primary care visit, if necessary, to help coordinate the completion of their quality health maintenance
Schedule appointments and testing and/or order screenings per standardized protocols
Maintain current knowledge of quality measure requirements
Scheduling patient appointments as needed for refills/barriers
Assisting other quality departments as needed per quarter
Demonstrate kindness and compassion in all patient interactions
Actively participate as a member of the health care team to promote positive health outcomes for our patients and support our healthcare partners
Participating in team building exercises/tools
Coordinate with pharmacy staff, primary care office staff and/or providers to ensure appropriate referrals, orders, and tests are in place for the patient
Contribute to increasing overall quality ratings for clinic by ensuring patients refill and take their medication on time and as directed
Identify opportunities for continuous process improvement