Overview
Job Duties
Under the supervision of RN Care Coordinator Manager, Primary Care performs tasks and patient contact to assist in the coordination of patient primary care services. Services include obtaining and running reports to assist with review and resolution of care gaps, improvement of Health Maintenance and HEDIS scores, transition of care from inpatient and Emergency care and other service settings.
Responsibilities
Essential Functions
- Reviews monthly Care Gap data from the Managed Care Department for Family Medicine and General Medicine clinics.
- Obtains and reviews daily ED visits reports to assist with identification of high ED utilizers.
- Contacts insurance Case Managers under the direction of the RN Care Coordinator Manager, and implements plans to follow up with patients, to include phone calls, video discussions to assist in preventing or reducing ED visits.
- Reviews Healthy Planet Performance of each clinic monthly and identifies measures that require improvement, and communicates to RN Care Coordinator Manager.
- Responsible for compliance with Health Maintenance and Centers for Medicare & Medicaid Services (CMS) guidelines..
- Assists with distribution of reports to individual clinics.
- Answer questions, assist with problems, and ensure goals, standards, and deadlines are met.
- Assists with maintenance of database and relationship with community resource providers.
- Maintain a positive customer service oriented disposition toward all clients and co-workers. Provide excellent customer service with internal and external customers.
- Prepares and maintains all clerical aspects of the medical records through established guidelines.
- Additional duties as assigned
Qualifications
Experience Requirements
2 years Medical assistant required
1 year GI or Procedural Specialty preferred
Education Requirements
High School Diploma or GED required
Certification/Licensure
Certified Medical Assistant (CMA) required within 6 months
Basic Life Support (BLS) required at time of hire
UFJPI is an Equal Opportunity Employer and Drug Free Workplace