Program Manager II
Centene Corporation
Analyst, Outreach Coordinator
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Massachusetts, Ohio
Visit company websiteSalary
💰 $21 - $37 per hour
Job Level
Mid-LevelSenior
About the role
- Help us elevate quality care via provider engagement and bring provider relationships to a whole new level! Be a part of our Aetna team- an industry leader serving the Medicare and Commercial lines of business. With compassionate attention and excellent communication, we collaborate with providers, vendors, and our internal partners to address care gaps, educational needs, and record collection for HEDIS® leading to positive outcomes for our members Join us in this exciting opportunity as we grow and expand to improve the quality of care across the country.
- Position Summary/Mission The Analyst, Outreach Coordinator utilizes several tools to help close care gaps throughout the year. The Analyst, Outreach Coordinator helps facilitate meetings with providers and internal partners to address gaps in care and assists in answering questions regarding all facets of the HEDIS® process, such as how to submit records to Aetna, measure specific questions, where to access information, etc. The Analyst/Outreach Coordinator will be the subject matter expert regarding HEDIS measures as well as help devise a plan to assist members with getting needed services.
- Subject Matter Expert in Healthcare Effectiveness Data and Information Set (HEDIS®) improvement work
- Interacts with providers and/or members to improve healthcare outcomes such as increased preventive care compliance
- Supports provider engagement
- Active participation in workgroups
- Delivers quality information to internal and external constituents via written and verbal communication
- Actively seeks opportunities for process improvement resulting in efficient and effective work streams
- Independently map out provider outreach work plans and execute deliverables
- Supports complex relationships with both internal and external constituents
- Consults with constituents on solutions to business issues including education and process improvement opportunities
- Support complex provider partners with HEDIS® gaps in care, digital solutions, and remote medical record collection discussions and education
- Work closely with the provider partner to enhance collaboration between provider and Aetna
- Provides support for HEDIS® quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services
- Supports effective medical record capture for HEDIS® medical record review and abstraction of supplemental data
- Public speaking
- Required Qualifications 3 years' recent and related health care experience in any setting 1+ years of Medicare experience and/or 1+ years of HEDIS medical record abstraction experience 1+ years member/provider education experience targeting gaps in care Experience successfully performing in an environment where daily/weekly productivity metrics are expected Ability to work independently Ability to use standard corporate software packages and applications Strong communication skills Preferred Qualifications Experience speaking with medical providers and/or medical office staff Recent and related experience working with HEDIS® Medicare Stars experience or health insurance experience Health care related experience in clinical, managed care or quality management Understanding of CPT/CPTII/ICD9/ICD10 coding and medical terminology
- Education Bachelors Degree OR equivalent experience in Healthcare
Requirements
- 3 years' recent and related health care experience in any setting
- 1+ years of Medicare experience and/or 1+ years of HEDIS medical record abstraction experience
- 1+ years member/provider education experience targeting gaps in care
- Experience successfully performing in an environment where daily/weekly productivity metrics are expected
- Ability to work independently
- Ability to use standard corporate software packages and applications
- Strong communication skills
