Raleigh, North Carolina
Posted: 06-Sep-24
Location: Los Angeles, California
Salary: Open
Categories:
Internal Number: 142129741
Population Health Quality Management supports Population Health initiatives to increase the quality of care, while maintaining cost-effective outcomes through targeted patient outreach and care gap closure. The Quality Outreach Specialist is responsible for medical record abstraction and outreach activities in support of maintaining and enhancing performance on quality measures in an ambulatory environment. This includes HEDIS and other value-based care quality, cost, and utilization measures.
The Quality Outreach Specialist will utilize standardized training materials to collect medical records that meet HEDIS specifications and facilitate outreach to complete gap closure activities. Outreach responsibilities include conducting and answering telephone calls, re-directing calls as appropriate, scheduling visits, and assisting patients with questions or concerns. A goal of this role is to close care gaps by maximizing medical record retrieval for quality measures (e.g. screening, immunization, and medication adherence) and create intervention-oriented reports that identify members in need of service gap closures.
Salary Range: $34.37-$47.31/hourly
Required:
- Bachelor's Degree or Associates Degree with equivalent years of relevant experience in medical field OR high school degree/GED with equivalent years of experience in the medical field
- Prior experience in population health or managed cared equivalent quality management programs
- Knowledge of Federal, State and local regulations and laws, including, but not limited to NCQA, HEDIS, CMS and DMHC as well as health plan standards and delegation requirements as they relate to quality management
- Ability to utilize Word, Excel and other software programs
- Ability to establish and maintain cooperative and collaborative working relationships with administrative, clinical and academic personnel
- Skill in working independently and following through with minimum direction
- Demonstrate writing skills to compose logical, detailed and grammatically correct correspondence
- Document patient care in a concise and comprehensive manner
- Excellent assessment skills
- Knowledge of efficient interviewing practices and techniques used in order to gather information
- Strong interpersonal skills with the ability to build relationships with providers and patients
- Excellent verbal and listening skills both in-person and on the phone required
- Excellent customer service skills required. Ability to be culturally sensitive and work with a diverse, geriatric patient population
- Knowledge of medical records and appropriate documentation requirements.
- Ability to maintain patient confidentiality required. Knowledge of HIPAA requirements
- Ability to remain calm and be resourceful in emergency situations required
- Ability to maintain a professional demeanor at all times
