What are the responsibilities and job description for the Community Health Coordinator position at Shenandoah Medical Center?
1. Analyze insurance portals and Allscripts to identify gaps in care of patients and effectively coordinate with the clinical team, scheduling team and patients resolve these gaps.
- Mine and extract data in various insurance databases and dashboards
- Maintain and revise attribution lists of patients to SMC providers
- Mine and extract data regarding gaps/completion in patient care
- Measure completion of HEDIS measures for various insurers
- Design, create, modify and present reports via data visualization in various designs (column, bar, pie chart)
- Work with the Accountable Care Organization in maintaining patient attribution, completing annual Medicare HEDIS measures and care gap closures
- Participate in payer quarterly quality meetings with the Medicaid Managed Care Organizations (MCO) and the ACO
2. Communicate effectively.
- Communicate and collaborate effectively with health team members.
- Identify and recognize abnormal symptoms/changes in patient condition. Appropriately, reports condition changes to medical provider.
- Complete proper patient reports after each contact with appropriate signature forms accurately completed and signed.
- Responsible for contacting participants that are eligible for the program for enrollment and provides necessary wellness coaching to reduce or eliminate high-risk behaviors.
- Encourages adoption of habits that are conducive to a higher quality of life.
3. Performs other duties as assigned.
Experience
Preferred- Graduate of an accredited LPN school of nursing or CMA course completion preferred but not required
- Previous experience in data analysis
Education
Required- High School or better
