Population Health Assistant Job at Advocate Health Care (Oak Brook)

Job Description

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Job Responsibility

Provides, initiates, and prioritizes a variety of confidential population health activities which include but are not limited to telephonic outreach for care gap closure, resource and information gathering, communicating with clinicians, members, patients, insurance companies, and internal partners
Performs telephonic care gap outreach by utilizing established criteria through generated lists of culturally diverse patient populations requiring intervention and provides support to assist patients with scheduling appointments, coordinating services, and efficiently documenting outcomes and engagement
Communicates effectively with patients, clinicians, and other internal and external stakeholders to coordinate health care needs
Collaborates with internal and external stakeholders to coordinate obtaining test results or other relevant health information, update the patient’s electronic medical record, and assist with scheduling visits and/or other healthcare related services
Coordinates intake of cases on new and established assignments to expedite the Care Coordination process by facilitating the medical review process, verifying health plan eligibility, obtaining and assessing preliminary clinical and non-clinical data or needed additional data, determining appropriate case type, and triaging to the appropriate resource
Initiates and advances the Care Coordination plan, monitors status and advises regarding requirements, process and status
Researches, organizes and maintains the team's library of resources, guidelines and policies
Performs medical literature review searches to support the department
Facilitates implementation of new employer groups in collaboration with Onsite Nurse and sales staff
Insures adequate onboarding materials are available and interim reporting tools and processes are in place
Coordinates implementation of care gap outreach
Utilizes established criteria to generate lists of members requiring intervention and to process reminders according to established protocols
Verifies list accuracy and documentation of interventions
Assists in development and training of new employee department members in areas such as information system programs, individual health plans, and policies and procedures
Trains and educates provider office staff in referral/authorization process and procedures, contracts, standards, benefit plan limitations, and resource/contact liaisons
Develops and generates reports, as well as gathers, compiles and summarizes data for reporting and analysis by staff, management and external partners
Assists in monitoring, tracking and analyzing data
Coordinates development, ordering and stocking of materials to support Population Health activities
Initiates design based on branding guidelines and business needs
Oversees and/or maintains department files, binders, records, logs, etc
Identifies need of additional record keeping and establishes same
Performs a variety of routine and moderately complex administrative duties such as screening incoming telephone calls
open, sort and route incoming mail and faxes
typing letters, memos and reports
monitoring office equipment
purchasing/ordering of equipment or supplies

Requirements

High School Graduate
Typically requires 5 years of experience in population health management, utilization management, claims, health insurance processing, clinical or care management/quality environment
Proficiency in the use of ICD-10, CPT and HCPCS coding preferred
Knowledge of medical terminology
Ability to manage data systemically
Demonstrates organizational ability and attention to detail and accuracy
Advanced skills and knowledge in the use of Microsoft Office (Excel, PowerPoint and Word), Internet explorer and similar products
Excellent organizational, interpersonal, and communication skills (written and verbal) with the ability to effectively communicate with a variety of individuals
Exercises independent judgment and demonstrate excellent problem-solving skills while able to still work well within a team
Ability to demonstrate self-direction in prioritizing and accomplishing job responsibilities
Ability to maintain a high degree of confidentiality

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

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Population Health Assistant

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