Job Title: Patient Care Advocate
Duration: 5 months Contract (Possibility to extend)
Location: Remote – Newark, DE (within 30 minutes driving distance between Newark and Wilmington, DE).
Shift Type: 8-5 Mon-Fri
Job Duties:
• Works with members and providers to close care gaps, ensure barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction with members and providers at large IPA and/or group practices.
• Serves to collaborate with providers in the field, to improve HEDIS measures and provides education for HEDIS measures and coding.
• Supports the implementation of quality improvement interventions and audits in relation to plan providers.
• Assists in resolving deficiencies impacting plan compliance to meeting State and Federal standards for HEDIS.
• Conducts telephonic outreach, while embedded in the providers' offices, to members who are identified as needing preventive services in support of quality initiatives and regulatory/contractual requirements.
• Provides education to members regarding the care gaps they have when in the providers office for medical appointments.
• Schedules doctor appointments on behalf of the practitioner and assists member with wraparound services such as arranging transportation, connecting them with community-based resources and other affinity programs as available.
• Maintains confidentiality of business and protected health information.
Skills:
• Knowledge of HEDIS/Preventive screening recommendations
• Must haves 4 years of experience.
• Communication and Interpersonal Skills
• Understanding of Provider Practice Scheduling
• Problem Solving and Resource Coordination
Education/Certification Required:
• Bachelor’s degree in healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field or equivalent work experience required (a total of 4 years of experience required for the position.
• Preferred: Will take RN/LPN with 4 years’ experience in lieu of bachelor’s degree. (Can have Associate’s degree)
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