Patient Care Advocate

Spectraforce Technologies, Inc.; Eugene (OR); On-site; USD 30,000 - 39,000; Full time

Job summary

Spectraforce Technologies, Inc. seeks a Patient Care Advocate in the Eugene, OR area to work field-based with members and providers, closing care gaps and improving HEDIS outcomes.

Responsibilities include after-hours outreach, appointment scheduling, and education on HEDIS measures and NCQA coding specifics, with thorough documentation and cross-team collaboration.

Qualifications

• Must have HIPAA training or be HIPAA-certified.
• Ability to flex between groups and work with diverse teams.
• Resident of the assigned area and able to travel within the region as needed.

Responsibilities

• Act as liaison between members, families, physicians, facilities and community agencies.
• Represent the organization with providers and staff at assigned practices.
• Educate practices on HEDIS measures and NCQA-compliant coding (ICD-10/CPT).
• Review provider performance data and develop improvement strategies.
• Coordinate with Provider Relations to enhance Quality, Risk Adjustment and Operations outcomes.
• Schedule physician appointments to close care gaps and ensure preventive care access.
• Conduct face-to-face education with members in provider offices.
• Perform telephonic outreach and health coaching for quality and regulatory needs.
• Coordinate transportation and follow-up appointments for members.
• Maintain accurate documentation of member outreach and actions.

Skills

HIPAA training

Group flexibility

Local residency

Education

High School Diploma

Healthcare Certification

Job description

Position Title: Patient Care Advocate

Work Location: Eugene Area, Oregon (OR)

Assignment Duration: 2 Months

Work Schedule: Monday-Friday, with potential evening and weekend hours (PST)

Work Arrangement: Field-Based / Member-Facing (Not Remote; Not at a Client Facility)

Position Summary

The Patient Care Advocate works directly with members and healthcare providers to close care gaps, remove barriers to care, and improve the overall member and provider experience through outreach and face-to-face interactions. This role involves working within large IPA and/or group practices, collaborating with providers to improve HEDIS performance, and providing education on HEDIS measures and appropriate coding practices.

Background & Context

The role supports a limited, outcome-based Member Navigation Program for identified Oregon Medicare members with verified open gaps in specific HEDIS measures. The primary objective is to improve HEDIS gap closure through after-hours outreach, direct appointment scheduling, appointment reminders, referral navigation, and verified completion tracking, supported by expanded-hours appointment access.

Key Responsibilities

• Act as a liaison and member advocate between members, their families, physicians, healthcare facilities, and community agencies.
• Represent the organization within the provider community, serving as its primary point of contact with providers and office staff at assigned practices.
• Educate provider practices on appropriate HEDIS measures and HEDIS-related ICD-10/CPT coding in accordance with NCQA requirements.
• Review provider performance data to identify improvement opportunities and develop strategies to enhance performance.
• Collaborate with Provider Relations to improve provider performance in Quality, Risk Adjustment, and Operations (claims and encounters).
• Schedule physician appointments for members with identified care gaps to ensure access to necessary preventive care services.
• Conduct face-to-face education with members and their families in provider offices regarding identified care gaps and potential barriers to care.
• Perform telephonic outreach and health coaching to support quality improvement and regulatory and contractual requirements.
• Coordinate transportation and follow-up appointments for members as needed.
• Maintain accurate documentation of all member-related outreach and actions taken.
• Collaborate with other departments, including Customer Service, to resolve member issues.
• Refer members to Case Management or Disease Management programs when appropriate.
• Complete special assignments and projects that support departmental objectives.
• Perform other duties as assigned. Comply with all organizational policies, procedures, and standards.

Education / Certification

Required: High School Education

Preferred: Certification in Healthcare

Licensure

Required: None

Preferred: CNA/MA/RN

Years of Experience Required

3

Additional Qualities to Look For

• 1 Patient care experience, front of clinic or back of clinic okay, HIPAA training
• 2 Ability to flex between groups
• 3 Live in area assigned

Top 3 Must-Have Hard Skills Stack-Ranked by Importance

• Top 3 must-have hard skills stack-ranked by importance