Patient Success & Utilization Specialist

Fhccgla; Bell Gardens (CA); Hybrid; USD 30,000 - 32,000; Full time

Benefits offered by this job

Medical benefits (Kaiser/Blue Cross)

Paid time off

Dental and vision benefits

Life insurance

Holiday and sick leave

401(k) with company match

Employee assistance program

Job summary

FHCCGLA is seeking a Patient Retention & Utilization Specialist in the Quality Improvement department in Los Angeles. The role focuses on engaging patients to retain services and maximize utilization across Women’s Health, Behavioral Health, Dental, Optometry, Nutrition, and Podiatry.

The candidate will work with the CIO and risk management to develop strategies, coordinate resources, and address barriers to care. Evening/weekend shifts may be required; bilingual English/Spanish preferred.

Qualifications

• High school diploma or GED required.
• FQHC experience preferred.
• Excellent analytical and reasoning skills.
• Strong written and oral communication abilities.
• Bilingual English and Spanish preferred.
• Proficient with NextGen EHR/PMS and MS Office.

Responsibilities

• Develop strategies to improve patient retention and utilization of FHCCGLA services.
• Collaborate with departments to enhance access to care and reduce no-show rates.
• Educate patients about available health services across programs.
• Coordinate transportation assistance to improve appointment adherence.
• Respond to patient inquiries and ensure high-quality customer service.
• Maintain HIPAA compliance and accurate documentation in PMS.

Skills

Analytical skills

Communication skills

Interpersonal skills

Problem solving

Time management

Bilingual English/Spanish

Adaptability

Education

High school diploma or GED

Tools

NextGen EHR/PMS

MS Word

Excel

PowerPoint

Job description

Overview

“To enhance the quality of life for men, women and children in the greater Los Angeles area through the provision of high quality, accessible and affordable healthcare services.”

We offer fantastic benefits, competitive pay, and a great family-oriented environment!

We offer:

• Medical Benefits - FHCCGLA pays 100% of employee’s Kaiser; Anthem Blue Cross; Health Net; and United Health Care coverage (HMO Plan) subject to change during open enrollment.

• 403 B - Through Mutual of America, the company matches up to 5% of employee’s salary.

• Dental Benefit - MetLife Only (HMO/PPO Plan).

• 11 Holidays Observed.
• 2 Floating Holidays

• Vision Benefit -MetLife Plan.

• 1 Birthday Holiday

• Life Insurance - Accidental Death & Dismemberment; and Long-term Disability.

• 7 Paid Sick Leave - 56 hours Full-Time
• Paid Sick Leave – 40, Part-Time and Per-Diem

• Employee Assistance Program

• 2 weeks’ Vacation

• AFLAC Benefits

This would be a great opportunity to make a difference with you onboard!

POSITION TITLE:Patient Retention & Utilization Specialist

DEPARTMENT: Quality Improvement

REPORTS TO: Quality Improvement (Q.I.) / Risk Management Coordinator

POSITION OVERVIEW:

The Patient Retention & Utilization Specialist is responsible to contact all applicable patients to attempt retention efforts and/or ensure increased utilization of all needed FHCCGLA services. The primary focus of this position will be maintaining patient retention and maximizing utilization of services. Shall outreach to active and non-active patients who have not received services within the recommended periodicity.

Responsibilities

DUTIES/RESPONSIBILITIES:

Responsible for establishing and implementing strategies to improve utilization and retain patients through changes.

Collaborates with other departments to increase retention, utilization and access to care and services as needed.

Enhance communication with patients regarding FHCCGLA services to improve quality service, reduce no-show rates, retain patients and ensure utilization of all services such as:

■ Women’s Health

■ Behavioral Health

■ Dental

■ Optometry

■ Nutrition

■ Podiatry

Works in conjunction with quality improvement department with guidance from the C.M.O. to develop and implement strategies to better engage and retain patients.

Contacts new and non-active patients to connect them to pertinent care services.

Responds to patients’ inquiries and follows-up on patient issues and resolutions to ensure quality customer service.

Coordinates resources to improve patient ability to adhere to appointments, including assistance with transportation.

Maintains knowledge of eligibility, enrollment, and program specifications for CHDP, Medi-Cal, Medicare and other insurance programs.

Conducts GAP reports from, NextGen and COZEVA to track utilization of services and determine which patients are due for various preventive care health maintenance measures and follow-up.

Follows all FHCCGLA safety, regulations, practices and policies & procedures.

Works with the operations managers to manage patient scheduling and flow to address bottlenecks, scheduling issues, etc. – notifies supervisor of all concerns.

Ensures HIPAA compliance by maintaining strict confidentiality of all patient data and E.H.R./Practice Management System (PMS) according to regulations and FHCCGLA’s P&P’s.

Remains informed of specific programs/payors, insurances accepted, and services being offered at FHCCGLA.

Serves as a liaison between clients and medical staff.

Assists clients with completion of forms.

Educates clients regarding available benefits (health coverage programs) and will refer directly to FHCCGLA outreach & enrollment specialists for eligibility screening and/or application assistance.

Participates in key pertinent meetings, such as:

■ Quarterly Staff (Q.S.) Training

■ Q.I./Q.A.

■ Medical Advisory Committee (M.A.C.), as needed

■ Etc.

All other tasks as assigned.

Qualifications

MINIMUM QUALIFICATIONS:

High school diploma, minimum (or GED equivalent).

FQHC experience, highly preferred.

Excellent analytical & reasoning skills.

Motivation to take initiative and multi-task to ensure all tasks performed are completed thoroughly, accurately and with minimal or no errors.

Excellent writing and verbal communication skills. Highly enthusiastic, approachable and confident communication style capable of motivating others.

Knowledge of administrative principles and procedures.

Computer knowledge preferred (e.g., NextGen (E.H.R. & PMS), Microsoft Word, Excel & PowerPoint).

Ability to adapt to changing schedules, deadlines and demands, and a heavy workload (e.g., late entry to stay late to contact patients unable to reach).

Must be able to communicate effectively, in both English & Spanish, verbally and written.

Exercises good judgment and professionalism when dealing with all FHCCGLA patients.

Ability to work with patients and staff from diverse socio-economic, ethnic and cultural backgrounds, preferred.

Strong interpersonal and problem-solving skills, to include persuasiveness, assertiveness and sensitivity when dealing with patients as well as agency staff.

Willingness to adapt to changes in clinic schedules, agency growth and expansion.

Ability to function self-sufficiently, requiring little supervision.

Commitment to the mission & vision of Family Health Care Centers of Greater Los Angeles, Inc.

Transportation required. Will need to travel to FHCCGLA clinic sites as necessary.

Evenings and weekends may be required, with advanced notice when feasible.

Current California Driver License.

ADDITIONAL ELIGIBILITY QUALIFICATIONS:

Ability to work well with others in a professional and team-oriented environment.

Well-developed interpersonal skills, friendly personality and able to motivate staff by promoting teamwork.

Willingness to travel.

Strong planning and organizational skills.

Problem analysis and critical thinking skills.

Excellent customer service skills.

Knowledge of the following (but not limited to), preferred:

■ My Health LA

■ PPO’s

■ HMO’s

■ Medicare

■ Family PACT

■ CHDP

■ Medi-Cal

■ Managed Care Plans

Min (For Export)

22.00

Max (For Export)

22.91