QUALITY PERFORMANCE COORDINATOR - CSNP

Liberty Health; Wilmington (NC); On-site; USD 42,000 - 64,000; Full time

Job summary

Liberty Health in Wilmington, NC is seeking a Quality Performance Coordinator for the CSNP program to monitor, report, and improve medication adherence among members.

The role involves identifying at-risk individuals via claims data, conducting outreach, educating members, addressing barriers, and presenting QA findings to an interdisciplinary team. Strong communication and data documentation skills are required.

Qualifications

• High school graduate, or equivalent, required.
• Proficiency with computer basics, including email and Microsoft Word/Excel.
• Strong written and verbal communication skills; ability to write reports and correspondence.
• Ability to meet deadlines and manage time effectively in a changing environment.
• Experience with vulnerable or underserved populations preferred.

Responsibilities

• Identify members at risk for medication non-adherence using pharmacy claims and internal reports.
• Conduct telephonic outreach to assess medication adherence and barriers.
• Educate members on medication adherence and disease self-management.
• Assist with closing member barriers.
• Develop a report and present to interdisciplinary team on identified barriers and solutions.
• Communicate effectively across the care continuum.
• Document member information in the electronic medical record.
• Coordinate information gathering for care needs with member and family.
• Support QA data collection and presentation for the CSNP program.
• Monitor HEDIS metrics and relay needs to the team.
• Analyze data to prioritize high-risk members for follow-up.
• Assist with quality measures compliance for CSNP.

Skills

Communication skills

Telephone outreach

Data analysis

EMR documentation

Adherence education

Team collaboration

Attention to detail

Education

High School Diploma

Tools

Microsoft Office

Excel

Email

Job description

QUALITY PERFORMANCE COORDINATOR - CSNP

There’s no place like Liberty Health

Come explore career opportunities with Liberty 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

Background checks/drug-free workplace.

EOE.