Overview
Department:
Quality - Quality Care Improvement Location:
600 City Parkway West 10th Floor, Orange, CA 92868 Compensation:
$20.00 - $25.00 / hour We are currently seeking a highly motivated Patient Engagement Specialist I in the Orange County area. This role will report to the Manager – Quality Care Improvement and enable us to scale in the healthcare industry. As a Patient Engagement Specialist, you’ll focus on outreach to members, assist with scheduling, and retrieve records through portals, EMRs, or on-site provider visits to support gap closures.
What You'll Do
Conduct outreach calls to inform patients of recommended services for HEDIS measure gap closure in a courteous and engaging manner
Requests and gathers necessary medical records as needed
Effectively organize projects and tasks based on priority to help meet expectations and deadlines of projects
Collaborates with the health plan, PCP, and health care team to ensure timely communication of member's clinical information
Generates letters and faxes to PCPs, Specialists, patients, and other health care team members
Analytical problem solving with the ability to understand the overall picture
Coordinate care for patients as appropriate such as scheduling appointments, creating authorizations to facilitate/expedite patient’s requests based on provider’s orders
Maintain strict confidentiality of business discussions
Travel to various offices as designated
Ad-hoc projects as assigned by the manager/supervisor
May be required to work overtime to meet tight deadlines
Comply with department policy and procedures
Collect and collate appropriate data from IPA network providers for HEDIS measures
Collect medical records, conduct reviews and ensure accuracy of documentation for reporting
Collect, summarize and trend provider performance data to include provider education
Participate in ongoing discussions concerning data collections and analysis for HEDIS
Assist in planning and implementation of projects to improve delivery of services and quality of care
Understand the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards and HIPAA
Generate and maintain accurate weekly/monthly/quarterly report of activities
Attend to health plans, provider, and interdepartmental calls
Qualifications
Minimum of Associate's degree, Bachelor’s degree or equivalent years of experience
Experience using Microsoft applications such as Word, Excel and Outlook
Proficiency in electronic scheduling
At least one (1) year of HEDIS related experience
Must have Driver’s License, reliable transportation and be willing to travel between office locations as needed
Ability to prioritize and effectively multi-task
Ability to quickly adapt to various situations
Excellent organizational skills and strong attention to detail
Effective and professional communication skills
Self-driven, quick learner, patient, must be able to work with people of different personalities
You're great for the role, if
Fluent in Spanish
1-3 years of IPA/MSO/HP or general healthcare experience
Excellent analytical critical reasoning and interpersonal communication skill
Ability to work in a fast-paced environment
Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The home office of this department is located at 600 City Parkway West, 10th Floor, Orange, CA 92868.
The total compensation target pay range for this role is $20.00 - $25.00 per hour. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at
humanresourcesdept@astranahealth.com
to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
#J-18808-Ljbffr
Department:
Quality - Quality Care Improvement Location:
600 City Parkway West 10th Floor, Orange, CA 92868 Compensation:
$20.00 - $25.00 / hour We are currently seeking a highly motivated Patient Engagement Specialist I in the Orange County area. This role will report to the Manager – Quality Care Improvement and enable us to scale in the healthcare industry. As a Patient Engagement Specialist, you’ll focus on outreach to members, assist with scheduling, and retrieve records through portals, EMRs, or on-site provider visits to support gap closures.
What You'll Do
Conduct outreach calls to inform patients of recommended services for HEDIS measure gap closure in a courteous and engaging manner
Requests and gathers necessary medical records as needed
Effectively organize projects and tasks based on priority to help meet expectations and deadlines of projects
Collaborates with the health plan, PCP, and health care team to ensure timely communication of member's clinical information
Generates letters and faxes to PCPs, Specialists, patients, and other health care team members
Analytical problem solving with the ability to understand the overall picture
Coordinate care for patients as appropriate such as scheduling appointments, creating authorizations to facilitate/expedite patient’s requests based on provider’s orders
Maintain strict confidentiality of business discussions
Travel to various offices as designated
Ad-hoc projects as assigned by the manager/supervisor
May be required to work overtime to meet tight deadlines
Comply with department policy and procedures
Collect and collate appropriate data from IPA network providers for HEDIS measures
Collect medical records, conduct reviews and ensure accuracy of documentation for reporting
Collect, summarize and trend provider performance data to include provider education
Participate in ongoing discussions concerning data collections and analysis for HEDIS
Assist in planning and implementation of projects to improve delivery of services and quality of care
Understand the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards and HIPAA
Generate and maintain accurate weekly/monthly/quarterly report of activities
Attend to health plans, provider, and interdepartmental calls
Qualifications
Minimum of Associate's degree, Bachelor’s degree or equivalent years of experience
Experience using Microsoft applications such as Word, Excel and Outlook
Proficiency in electronic scheduling
At least one (1) year of HEDIS related experience
Must have Driver’s License, reliable transportation and be willing to travel between office locations as needed
Ability to prioritize and effectively multi-task
Ability to quickly adapt to various situations
Excellent organizational skills and strong attention to detail
Effective and professional communication skills
Self-driven, quick learner, patient, must be able to work with people of different personalities
You're great for the role, if
Fluent in Spanish
1-3 years of IPA/MSO/HP or general healthcare experience
Excellent analytical critical reasoning and interpersonal communication skill
Ability to work in a fast-paced environment
Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The home office of this department is located at 600 City Parkway West, 10th Floor, Orange, CA 92868.
The total compensation target pay range for this role is $20.00 - $25.00 per hour. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at
humanresourcesdept@astranahealth.com
to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
#J-18808-Ljbffr