About the role
OverviewJob DutiesUnder the supervision of RN Care Coordinator Manager, Primary Care performs tasks and patient contact to assist in the coordination of patient primary care services. Services include obtaining and running reports to assist with review and resolution of care gaps, improvement of Health Maintenance and HEDIS scores, transition of care from inpatient and Emergency care and other service settings.
Details
- Schedule
- FULL_TIME
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- Job DutiesUnder the supervision of RN Care Coordinator Manager, Primary Care performs tasks and patient contact to assist in the coordination of patient primary care services. Services include obtaining and running reports to assist with review and resolution of care gaps, improvement of Health Maintenance and HEDIS scores, transition of care from inpatient and Emergency care and other service settings. ResponsibilitiesEssential Functions
- Reviews monthly Care Gap data from the Managed Care Department for Family Medicine and General Medicine clinics.
- Obtains and reviews daily ED visits reports to assist with identification of high ED utilizers.
- Contacts insurance Case Managers under the direction of the RN Care Coordinator Manager, and implements plans to follow up with patients, to include phone calls, video discussions to assist in preventing or reducing ED visits.
- Reviews Healthy Planet Performance of each clinic monthly and identifies measures that require improvement, and communicates to RN Care Coordinator Manager.
- Responsible for compliance with Health Maintenance and Centers for Medicare & Medicaid Services (CMS) guidelines..
- Assists with distribution of reports to individual clinics.
- Answer questions, assist with problems, and ensure goals, standards, and deadlines are met.
- Assists with maintenance of database and relationship with community resource providers.
- Maintain a positive customer service oriented disposition toward all clients and co-workers. Provide excellent customer service with internal and external customers.
- Prepares and maintains all clerical aspects of the medical records through established guidelines.
- Additional duties as assigned QualificationsExperience Requirements2 years Medical assistant required1 year GI or Procedural Specialty preferredEducation RequirementsHigh School Diploma or GED requiredCertification/LicensureCertified Medical Assistant (CMA) required within 6 monthsBasic Life Support (BLS) required at time of hireUFJPI is an Equal Opportunity Employer and Drug Free Workplace
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