Telephonic Quality Outreach Professional

Humana • Oklahoma City, OK

2d • Hybrid

About The Position

The Telephonic Quality Outreach Professional supports the EPSDT program requirements in a telephonic outreach environment by evaluating member needs and helping families achieve or maintain an optimal state of wellness. The Telephonic Outreach Care Coach Professional 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on straightforward moderate complexity assignments that are routine and structured in nature. The Telephonic Quality Outreach Professional employs a variety of strategies and techniques to coordinate services and resources that facilitate HEDIS gap closure and improve pediatric health outcomes. The supervisor limits decisions to defined parameters around work expectations, quality standards, priorities and timing, and supervises closely and/or works within established policies/practices and guidelines with minimal opportunity for deviation.

Requirements

• Unrestricted Licensed Practical Nurse (LPN) in the state of Oklahoma
• Remote/hybrid- 2 days a week in office
• Prior experience in a insurance or health care setting
• At least 2 years of technical experience
• Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint
• Must be passionate about contributing to an organization focused on improving consumer experiences

Nice To Haves

• Bilingual -Spanish
• Experience working with Medicaid members to coordinate services, care needs, or benefits
• Prior experience working with HEDIS measures or quality performance metrics
• Remote or Telephonic experience
• Knowledge of community health and social service agencies and additional community resources

Responsibilities

• Telephonic outreach to close HEDIS gaps for Medicaid pediatric population
• Assist members in addressing barriers to care, including scheduling challenges and transportation needs, to support access to primary care and overall well-being
• Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator related to strategic outreach to maximize HEDIS outcomes
• Collaborate with other departments
• Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines
• Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs
• Other responsibilities as assigned

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed