Onsite Patient Care Advocate & Provider Liaison

Spectraforce Technologies; Newark (DE); Presencial; USD 42 000 - 62 000; Tempo integral

Resumo da oferta

Spectraforce Technologies is seeking a Patient Care Advocate to work onsite in Newark, DE. The role focuses on closing care gaps, educating providers on HEDIS measures, and improving member and provider experiences through face-to-face outreach.

Responsibilities include coordinating care with providers, scheduling preventive visits, and conducting health coaching to support quality improvement and regulatory requirements in a managed care environment.

Qualificações

• Bachelor's degree or equivalent required in a healthcare-related field.
• Minimum 2 years of direct patient care, social work, quality improvement or health coaching experience.
• Preferred RN, LPN, LMSW, LSW, or Certified Social Worker licensure or equivalent.
• Experience in managed care settings is a plus.

Responsabilidades

• Acts as a liaison between member/family, physician, and facilities.
• Represents the organization in provider communities embedded in provider offices.
• Educates providers on HEDIS measures and coding per NCQA requirements.
• Assesses provider performance data to identify improvement opportunities.
• Collaborates with Provider Relations to enhance quality, risk adjustment, and claims/encounters.
• Schedules appointments for members with care gaps to access preventive care.
• Conducts face-to-face member education in providers' offices about gaps and barriers to care.
• Performs telephonic outreach and health coaching to support quality improvement and regulatory requirements.
• Arranges transportation and follow-up appointments as needed.
• Documents all member-related actions and interacts with customer service to resolve issues.

Conhecimentos

Excellent customer service

Member outreach

Care gap closure

Health coaching

Medicaid/Medicare knowledge

Formação académica

Bachelor's degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related field

Descrição da oferta de emprego

Spectraforce Technologies is seeking a Patient Care Advocate to work onsite in Newark, DE. The role focuses on closing care gaps, educating providers on HEDIS measures, and improving member and provider experiences through face-to-face outreach.

Responsibilities include coordinating care with providers, scheduling preventive visits, and conducting health coaching to support quality improvement and regulatory requirements in a managed care environment.