QUALITY PERFORMANCE COORDINATOR - CSNP

Liberty Health; Kirkland (NC); On-site; USD 45,000 - 65,000; Full time

Job summary

Liberty Health seeks a Quality Performance Coordinator – CSNP to identify members at risk of non-adherence and coordinate outreach to support medication adherence and disease self-management.

The role requires collaboration with the interdisciplinary team, data analysis to prioritize high-risk members, and ongoing education for patients and caregivers as part of CSNP and QA activities.

Qualifications

• High school diploma or equivalent is required.
• Knowledge of community resources is preferred.
• Experience with behavioral health populations is preferred.
• Experience working with low income and disadvantaged populations is preferred.
• Experience with vulnerable adults or senior populations is preferred.
• Proficient with Microsoft Word and Excel.

Responsibilities

• Identify members at risk for medication non-adherence using pharmacy claims and internal reports.
• Conduct telephonic outreach to assess medication adherence and identify barriers.
• Educate members on the importance of medication adherence and disease self-management.
• Assist with closing member barriers.
• Develop a report and present to interdisciplinary team to discuss barriers and potential solutions.
• Communicate effectively with individuals across the care continuum.
• Document member information in the electronic medical record.
• Communicate with member and/or family regarding care and needs.
• Recommend and/or conduct in-service or continuing education with patients and caregivers as appropriate.
• Monitor HEDIS metrics and communicate needs to interdisciplinary team.
• Analyze data to prioritize high-risk members for follow-up and intervention.
• Assist with compliance of quality measures for CSNP program.
• Assist with HEDIS measures and collection of data.
• Assist with collection and presentation of QA data for the CSNP program.
• Performs other duties as assigned.

Education

High school graduate or equivalent

Job description

Come explore career opportunities withLiberty Health, a dynamic leader in the healthcare industry. Join us!

We are currently seeking an experienced:

QUALITY PERFORMANCE COORDINATOR – CSNP

JOB SUMMARY:

• Identify members at risk for medication non-adherence using pharmacy claims and internal reports.
• Conduct telephonic outreach to assess medication adherence and identify barriers.
• Educate members on the importance of medication adherence and disease self- management.
• Assist with closing member barriers.
• Develop a report and present to interdisciplinary team to discuss identified barriers and potential solutions.
• Communicate effectively with individuals across the care continuum.
• Documents member information in the electronic medical record.
• Communicate with member and/or family obtaining and providing information regarding care and needs.
• Recommends and/or conducts specific areas of in-service or continuing education with patients and caregivers as appropriate.
• Monitor HEDIS metrics and communicate needs to interdisciplinary team.
• Analyze data to prioritize high-risk members that need follow up and intervention.
• Assists with compliance of quality measures for CSNP program
• Assist with HEDIS measures and collection of data
• Assist with collection and presentation of QA data for the CSNP program
• Performs other duties as assigned

JOB REQUIREMENTS:

• High school graduate, or equivalent, required
• Knowledge of community resources, preferred
• Previous experience working with behavioral health populations, preferred
• Experience working with low income and disadvantage populations, preferred
• Previous work with vulnerable adults or senior populations, preferred
• Must be able to demonstrate computer skills, including use of e-mail and Microsoft office word and excel
• Must be able to demonstrate effective written communication skills including but not limited to writing reports and correspondence
• Must be able to demonstrate effective verbal communication skills, including but not limited to speaking effectively to members, providers, families and staff and listening to members, providers and families
• Demonstrated ability to meet deadlines, and use time effectively and efficiently.
• Demonstrated successful experience working in an environment of change. Effectively copes with change and uncertainty; responds and "shifts gears" comfortably
• Is dedicated to meeting the expectations and requirements of both external and internal customers, acts with customers in mind
• Demonstrated ability to establish and maintain effective relationships with customers, and gain their trust and respect
• Uses logical methods to solve problems with effective solutions; looks beyond the obvious for solutions