[Hiring] Population Health Assistant @Advocate Health

Role Description

This position will be remote with occasional onsite needs and an annual meeting that will be in-person in either NC or GA. No relocation and no sponsorship or transfer of visa for this position now or in the future.

• Coordinates intake of cases on new and established assignments to expedite the Care Coordination process.
• Facilitates the medical review process, verifying health plan eligibility, obtaining and assessing preliminary clinical and non-clinical data.
• Determines appropriate case type and triages 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.
• Ensures 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 processes reminders according to established protocols.
• Verifies list accuracy and documentation of interventions.
• Assists in development and training of new employee department members.
• Trains and educates provider office staff in referral/authorization process and procedures.
• Develops and generates reports, gathers, compiles and summarizes data for reporting and analysis.
• 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.

Qualifications

• 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.

Requirements

• 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).
• Exercises independent judgment and demonstrates excellent problem-solving skills.
• Ability to demonstrate self-direction in prioritizing and accomplishing job responsibilities.
• Ability to maintain a high degree of confidentiality.

Benefits

• 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.