Population Health Outreach Specialist

Job Summary: The Population Health Outreach Specialist is an intricate part of the Population Health care team and contributes to the achievement of optimal outcomes for health plan members. Responsible for analyzing data to prioritize member needs and generate efficient workflows. Provides telephonic outreach to engage members, provide education on the Population Health Program and preventive screenings, and schedule visits with a nurse practitioner/physician assistant (NP/PA). Responsible for the coordination and timely completion of assigned provider schedules to ensure short-term and long-term departmental goals are met. Assists with other operational initiatives as they arise.

Essential Duties & Responsibilities:

• Schedule members for Population Health visits by the NP/PA via outbound telephone calls based on need of targeted population and departmental goals
• Provide education to members regarding the Population Health Program and health maintenance. This incudes education on any screenings the member may be due for and the importance of having those services completed
• Obtain order from NP/PA for needed screenings and schedule appointments for those services to be completed in the event a Population Health Visit cannot be done
• Create and analyze reports to help determine and prioritize appointment needs based off current departmental goals
• Prioritize tasks and alter workflows as needed to complete assigned schedules and meet departmental targets
• Provide mapping support to determine provider’s best route for home visits
• Verify insurance through multiple systems
• Input registration data into EMR (electronical medical record) after verifying accuracy
• Update demographic changes in multiple systems
• Maintain HIPAA compliance throughout workflow
• Update statuses after visit completion within multiple systems
• Create provider folders prior to Population Health Visits that include member specific information related to claims, diagnoses, and permissions
• Send disconnect letters to patients who are unable to be contacted
• Access, collect, and transfer member information from multiple data systems
• Fax, mail, and scan multiple documents
• Answer incoming calls from multiple entities, provide professional and effective communication, and direct calls to the appropriate personnel when needed
• Call from provider offices to assist with scheduling services or visits with the provider
• Provide accurate and relevant documentation within multiple systems
• Act as a resource to department in assisting with meaningful member outreach activities
• Communicate closely and effectively with department management and staff to determine optimal workflows for meeting short-term and long-term goals
• Maintain a consistent and optimal level of productivity for meeting targets and performance standards as required by management.

Marginal Duties:

• Other duties as assigned
• Floating to Affinity Population Health clinic, provider offices, or assisting NP/PA within the homes may be needed on occasion
• Assistance with patient compliance initiatives

Knowledge, Skills, and Abilities:

• High school diploma or equivalent required
• Must possess and maintain a valid Louisiana driver’s license
• 3 years of general health insurance, managed care experience and/or prior customer service experience is required
• 1 year of experience communicating with patients or plan members about clinical topics is preferred
• 1 year of electronic medical record experience is preferred
• 3 years of work experience where duties include problem solving and customer satisfaction preferred
• Clinical office experience preferred
• Excellent oral/written communication skills and knowledge of medical terminology are required.
• Effective interpersonal skills to handle numerous inquiries in professional manner with tact, diplomacy, and patience.
• Excellent listening skills are required to effectively handle patient’s needs/issues and demonstrate the ability to multi-task, prioritize work assignments and work independently
• Ability to analyze data and initiate effective workflows
• Advanced time management and problem-solving skills
• Punctual and regular attendance is required
• Demonstrates the ability to identify, make recommendations and act on opportunities and potential operational efficiencies within the department and offer solutions and recommendations to management.
• Possess efficient computer skills and have the ability to operate within multiple systems simultaneously
• Ability to adhere to defined metrics for monitoring productivity
• Workplace attitude must embrace patient centric behavior, organizational cultural beliefs and departmental requirements including efficiency, accuracy, adherence, and confidentiality of protected health information such as HIPAA.

Supervisory Responsibilities:

• This position has no supervisory responsibilities

Supervision Received:

• Works under general supervision of Population Health Nursing Supervisor and Population Health Regional Supervisor

Working Conditions:

• Travel may be required, but is reimbursed accordingly to travel policy
• Please see travel policy

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit, use hands and fingers, handle or feel, reach with hands and arms, and talk or hear. The employee may be required to stand and walk. The employee must regularly lift and/or move up to 10 pounds and frequently lift and/or move up to 30 pounds.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Vision insurance

Schedule:

• 8 hour shift

People with a criminal record are encouraged to apply

Work Location: In person