We are seeking a dedicated individual to join our Population Health Department, working closely with all Physician teams across our organization. As an integral support, you will assist providers and patients in achieving their healthcare goals and ensuring their care needs are met. Your professionalism and ability to communicate effectively will be key in explaining processes and educating both staff and patients.
Key Responsibilities:
Outreach to patients to schedule appointments, review medications, discuss post-hospital needs, and facilitate testing, ensuring proactive solutions to patient needs.
Consideration of patients' social needs and barriers, and referral to appropriate assistance when necessary.
Facilitation of after-hours calls for patients receiving remote monitoring of vital signs, and providing clinical assistance when appropriate.
Assistance with scheduling tests and treatments, maintaining patient records, and administering medications as ordered.
Providing courteous and friendly service to all patients and contributing to a positive work environment.
Essential Job Functions:
Independently utilizing sound clinical knowledge and skills.
Reviewing patient registries and data sets to identify care gaps and preventative health measures, communicating effectively to ensure timely closure of identified gaps.
Collecting and tracking process improvement/quality measure data, conducting analysis in collaboration with care teams to identify improvement activities.
Accessing daily reports to identify hospitalized, discharged, and Emergency Department-treated patients, providing follow-up communication and aiding in care coordination.
Providing information to patients and families regarding community resources, medication assistance, and healthcare needs.
Assisting patients with scheduling, ordering lab work, and testing needed for chronic diseases.
Conducting outreach to patients transitioning through multiple healthcare settings, completing Transition of Care follow-up for inpatient discharges and ensuring understanding of discharge instructions and medication reconciliation.
Minimum Qualifications:
Current Certified Medical Assistant (CMA) with experience in medication reconciliation.
Knowledge of discharge planning, transitions of care, and community resources preferred.
Minimum of two (2) years' recent healthcare experience, primary care experience preferred.
Experience and knowledge of electronic health records, medical terminology, CPT, and ICD-10 codes.
Effective communication and interpersonal skills, ability to maintain cooperative relationships with providers, staff, patients, and the medical community.
Strong organizational, research, and analysis skills with attention to detail.
Ability to function effectively in a fast-paced, service-oriented environment, maintaining confidentiality and employing tact, diplomacy, and compassion.
Proficiency in computer skills including Word, Outlook, Excel, with the ability to learn other software as needed. Experience with data analytics and quality metrics preferred.
Employment Type: Full-Time
Salary: $ 16.00 21.00 Per Hour
