Care Gap Navigator & Patient Advocate

BCforward; Elkhart (IN); On-site; USD 39,000 - 55,000; Full time

Job summary

BCforward is seeking a healthcare liaison to serve at WellCare-affiliated clinics in Indiana. The role educates providers on HEDIS measures and coding, coordinates care gaps, and supports quality improvement efforts in a managed care setting.

The position requires a bachelor's in a health field and 4 years of related experience, with 2+ years in direct patient care. Onsite work at designated health centers in Elkhart/Indianapolis, with a 3-month contract and potential extension.

Qualifications

• Bachelor’s degree in healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related field.
• 4 years of experience in direct patient care, social work, quality improvement or health coaching.
• 2+ years in direct patient care within a managed care environment preferred.

Responsibilities

• Acts as a liaison between member/family, physician and facilities.
• Represents WellCare in the provider community with office staff.
• Educates Provider practices in HEDIS measures and HEDIS ICD-10/CPT coding per NCQA.
• Analyzes provider performance data to identify improvement opportunities.
• Works with Provider Relations to improve quality, risk adjustment and operations.
• Schedules appointments for care gaps and coordinates preventive services.
• Delivers in-person and telephonic education to members and families.
• Arranges transportation and follows up on care needs; documents actions.
• Collaborates with other departments to resolve issues and complete special projects.

Skills

Communication

Health coaching

Provider relations

Patient advocacy

Education

Bachelor’s degree in healthcare or related field

Job description

BCforward is seeking a healthcare liaison to serve at WellCare-affiliated clinics in Indiana. The role educates providers on HEDIS measures and coding, coordinates care gaps, and supports quality improvement efforts in a managed care setting.

The position requires a bachelor's in a health field and 4 years of related experience, with 2+ years in direct patient care. Onsite work at designated health centers in Elkhart/Indianapolis, with a 3-month contract and potential extension.