Job Purpose:
To support the Management Service Organization in reaching out to plan members, thereby providing the education and support the members need in order to manage and improve their health.

Job Duties & Responsibilities:
• Assist the Program Coordinator in the Quality Improvement and Quality Assessment process for all lines of business.
• Conduct home visits and/or phone contact for member survey completion.
• Complete home visits for those members who are missing information or need updated info.
• Conduct home visits for members in need of follow up.
• Acquire information needed to close GAPs and help improve outcomes in members.
• Establish and nurture relationships with members in order to maximize interactions and health outcomes.
• Collaborate with EPO and provider offices to identify members in need of follow up.
• Daily review of email to review, prioritize and schedule outreach for members.
• Conduct welcome calls for new members, verify information and schedule appointments.
• Weekly meetings with Program Coordinator to review activity and plan for the following week.
• Assist Program Coordinator in ensuring members that are discharged from hospital are scheduled within 5 days of discharge.
• Assist Program Coordinator in monitoring ER frequent utilizers and coordinate with PCP staff to provide member intervention.
• Conduct reminder calls for members to verify prescriptions were picked up, ordered, or if assistance is needed in any of these..
• Participate in EPO training sessions and meetings as requested.
• Maintain exceptional communication with EPO and provider staff.
• Maintain current state certification.
• Other duties as assigned.

Reference : Medical Assistant jobs

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