KS Medicaid HEDIS Outreach Coordinator - Wichita
- Job Category: Healthcare/Medical
- Education: Bachelors Degree
- FT/PT: Full-Time
- Company: Aetna
- More Jobs from this Company
Implements an all product quality management strategy that meets internal andexternal constituent expectations for demonstrating quality outcomes. Usinginnovation, integration, and information links the quality managementactivities to business goals. Health Care Quality Management includes, but isnot limited to, QM Programs/Infrastructure, behavioral health QM,credentialing, delegation and regulatory
accreditation support, clinical and service measurement and improvement andquality of care investigations.
Facilitates provider and member outreach to ensure member receipt of importantclinical services to improvement member health outcomes. Provides support forHealthcare Effectiveness Data and Information Set (HEDIS) quality initiativesand regulatory/contractual requirements including outreach to members who arenoncompliant in the designated outreach services. Supports effective medicalrecord capture for HEDIS medical record review and abstraction of supplementaldata.
Identifies potential resources and initiates collaboration with providers toimprove member health outcomes and HEDIS measures.
Makes outbound calls to members to provide assistance in obtaining services(i.e., provide reminders, make appointments, arrange transportation, etc.) toavoid delays in treatment and improve member health outcomes. Identifies whento refer member to Social Worker or Case Manager.
Develops and distributes educational information to members and providers inaccordance with the HEDIS outreach work plan (mailings, social media,automated. calls, etc.)
Assists in the development and standardization of outreach documentation andmanages the data flow process to complete HEDIS documentation.
Documents member participation in outreach activities in accordance withabstraction and audit standards.
Conducts HEDIS provider chart request calls and mailings
May develop and maintain member incentive programs to support HEDISinitiatives.
Maintains incentive database to track member compliance.
May identify opportunities to partner with community organizations on specialevents and presentations (i.e., health fairs and community events). Works withinternal staff to schedule, organize, and staff these events.
Records and documents all member and provider outreach activity.
Performs other duties as required.
Minimum 3 years' recent and related health care marketing, outreach and/orhealth education experience.
Recent and related experience working with HEDIS criteria
Experience working in call center environment
Strong communication skills and experience speaking with medical providers.
Ability to work independently.
Ability to use standard corporate software packages and corporate applications;proficiency with MS Office Suite applications and strong keyboard navigationskills required.
Education and Certification Requirements:
Bachelor's degree or equivalent experience.
The highest level of education desired for candidates in this position is aBachelor's degree or equivalent experience.
Microsoft Word/1-3Years/End User
TE MicrosoftExcel/1-3 Years/End User
MicrosoftOutlook/1-3 Years/End User
MicrosoftSharePoint/1-3 Years/End User
ADDITIONAL JOB INFORMATION
Are you ready to join a company that is changing the face ofhealth care across the nation? Aetna Better Health of Kansas is looking forpeople like you who value excellence, integrity, caring and innovation. As anemployee, youll join a team dedicated to improving the lives of KanCaremembers. Our vision incorporates community-based health care that works. Wevalue diversity. Align your career goals with Aetna Better Health of Kansas,and we will support you all the way.
Aetna is about more than just doing a job. This is ouropportunity to re-shape healthcare for America and across the globe. We aredeveloping solutions to improve the quality and affordability of healthcare.What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired tomake a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualifiedapplicants will receive consideration for employment regardless of personalcharacteristics or status. We take affirmative action to recruit, select anddevelop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth,achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position.
Aetna takes our candidate's data privacy seriously. At no time will any Aetnarecruiter or employee request any financial or personal information (SocialSecurity Number, Credit card information for direct deposit, etc.) from you viae-mail. Any requests for information will be discussed prior and will beconducted through a secure website provided by the recruiter. Should you beasked for such information, please notify us immediately.
APPLY HERE: https://www.aetnacareers.com/job/wichita/ks-medicaid-hedis-outreach-coordinator-wichita/41/9043400/?z=1&codes=360Witchita&utm_source=360%20Wichita&utm_medium=Job%20Ads&utm_campaign=KS%20MCD