[Hiring] Quality Specialist @Summit Health

Role Description

As a Quality Specialist , you will be responsible for performing outbound patient calls regarding our clinical programs, medication adherence, and closing gaps in care for value-based contracted patients with clinical quality needs. The role will partner closely with our quality, population health, and pharmacy teams to effectively deliver wrap-around care for our patients. The ideal candidate will have the ability to work in a fast-paced environment while using excellent communication skills to serve our patients. They must be proactive with a strong personal initiative, as well as highly organized and detail oriented.

• Call patients to ensure they refill their chronic disease medications on time for diabetes, blood pressure, and cholesterol.
• Serve as liaison between patient, clinic, and pharmacy to minimize time missed between refills.
• Interpret patient medical history (medication list, office visit notes, etc.) and understand and properly communicate provider’s plan to patient.
• Navigate between different Electronic Medical Record (EMR) platforms to review patient medical information.
• Accurately and comprehensively document patient care activities in all applicable electronic records.
• Perform appropriate medication reconciliation by comparing how your patient is taking medication versus what is written in medical record and/or filled at the pharmacy.
• Request medication refills per clinic policy and protocol.
• Adequately assist patients with difficulties accessing medication due to cost or other barriers.
• Identify patients who need referrals to clinical pharmacist, retail pharmacy med sync program, retail pharmacy medication pack program, care management, clinician, and/or Village at Home.
• Timely follow up and persistent outreach to patients, providers, and pharmacies to ensure medications are picked up and taken as directed.
• Connect with patients before and after their primary care visit, if necessary, to help coordinate the completion of their quality health maintenance.
• Schedule appointments and testing and/or order screenings per standardized protocols.
• Maintain current knowledge of quality measure requirements.
• Scheduling patient appointments as needed for refills/barriers.
• Assisting other quality departments as needed per quarter.

Qualifications

• High school diploma or GED equivalent required.
• Certified Medical Assistant, Certified Pharmacy Technician, or equivalent experience in a healthcare setting required.
• Intermediate to advanced level keyboarding skills (at least 35 WPM, touch typing, formatting documents) required.
• 1+ years of experience in a healthcare setting preferred.
• Prior experience using an Electronic Health Record (EHR) preferred.
• Previous call center or telephonic experience preferred.
• Experience with Medicare Advantage plans, insurance, and medication adherence preferred.
• Bilingual English/Spanish preferred.

Requirements

• Secure workspace at home, including desk and chair, with minimum background noise required.
• Candidate supplied home internet access required.
• Minimum internet download speed of 100mbps and upload speed of 10mbps required.
• Internet to be hard-wired with an ethernet cord required. Wi-Fi connection cannot be used.

Benefits

• Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.