Telephonic Quality Outreach Professional

Humana; Oklahoma City (OK); Hybrid; USD 48,000 - 65,000; Full time

Job summary

Humana in Oklahoma City is seeking a Telephonic Quality Outreach Professional to support the EPSDT program by evaluating member needs and coordinating services to promote pediatric wellness. This role emphasizes telephonic outreach, collaboration with EPSDT teams, and adherence to Bright Futures guidelines to close HEDIS gaps.

The position requires an LPN in Oklahoma, at least 2 years in health care or insurance, and a remote/hybrid setup with 2 days in the office.

Qualifications

• Unrestricted Licensed Practical Nurse (LPN) in the state of Oklahoma.
• Remote/hybrid work—2 days a week in office.
• Prior experience in a health insurance or health care setting.
• At least 2 years of technical experience.
• Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint.
• Must be passionate about contributing to an organization focused on improving consumer experiences.

Responsibilities

• Telephonic outreach to close HEDIS gaps for Medicaid pediatric population.
• Assist members in addressing barriers to care, including scheduling challenges and transportation needs.
• Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator on strategic outreach to maximize HEDIS outcomes.
• Collaborate with other departments.
• Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines.
• Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs.
• Other responsibilities as assigned.

Education

Licensed Practical Nurse (LPN) in Oklahoma

Tools

Microsoft Office Word

Excel

PowerPoint

Job description

Become a part of our caring community

The Telephonic Quality Outreach Professional supports the EPSDT program requirements in a telephonic outreach environment by evaluating member needs and helping families achieve or maintain an optimal state of wellness. The Telephonic Outreach Care Coach Professional 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically work on straightforward moderate complexity assignments that are routine and structured in nature.

The Telephonic Quality Outreach Professional supports the EPSDT program requirements in a telephonic outreach environment by evaluating member needs and helping families achieve or maintain an optimal state of wellness. The Telephonic Outreach Care Coach Professional 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically work on straightforward moderate complexity assignments that are routine and structured in nature. The Telephonic Quality Outreach Professional employs a variety of strategies and techniques to coordinate services and resources that facilitate HEDIS gap closure and improve pediatric health outcomes. The supervisor limits decisions to defined parameters around work expectations, quality standards, priorities and timing, and supervises closely and/or works within established policies/practices and guidelines with minimal opportunity for deviation.

Position Responsibilities

• Telephonic outreach to close HEDIS gaps for Medicaid pediatric population
• Assist members in addressing barriers to care, including scheduling challenges and transportation needs, to support access to primary care and overall well-being
• Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator related to strategic outreach to maximize HEDIS outcomes
• Collaborate with other departments
• Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines
• Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs
• Other responsibilities as assigned

Required Qualifications

• Unrestricted Licensed Practical Nurse (LPN) in the state of Oklahoma
• Remote/hybrid- 2 days a week in office
• Prior experience in a insurance or health care setting
• At least 2 years of technical experience
• Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint
• Must be passionate about contributing to an organization focused on improving consumer experiences

Preferred Qualifications

• Bilingual -Spanish
• Experience working with Medicaid members to coordinate services, care needs, or benefits
• Prior experience working with HEDIS measures or quality performance metrics
• Remote or Telephonic experience
• Knowledge of community health and social service agencies and additional community resources

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$48,300 - $65,300 per year

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.