OVERVIEW OF THE POSITION:
Responsible for welcoming and orienting new and prospective dual-eligible patients to HealthCare Partners (HCP) systems and services, coordinating delivery of quality services through appropriate data gathering and resource referrals and acting as the primary point of contact to facilitate effective patient communication in support of the Care Team and Care Management “Core” team under the supervision of a Care Manager to ensure continuity of care and improve patient outcomes.
Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
Serves as a primary point of contact between patient and Care Team members to anticipate and appropriately address patient questions and concerns.
Confirms patient understanding of HCP Primary Care Physician (PCP) assignment and educates patient of available tools, resources, appropriate new services and benefits available.
Conducts Phase I of new patient orientation and assists patient with completing all HCP forms to facilitate patient understanding of HCP systems and services through the use of standardized scripts including mailings of welcoming packages, needed materials and thank you letters.
Initiates data gathering and completes documentation of Health Risk Appraisal (HRA) information for hand-off to Care Manager, ensures timely completion and review of HRA by Care Manager and facilitates availability of completed document for PCP.
Conducts telephonic outreach and ensures timely follow-ups after patient encounters with Emergency Department (ED) visits, Urgent Care Center (UCC) visits and inpatient hospitalizations through collaboration with PCP and ancillary staff to meet the treatment goals of patient.
Facilitates communication with patient and caregiver and coordinates patient care with appropriate resource allocations, referrals and notifications that are purposeful, supportive and interconnected with Care Team Members to ensure ongoing coordinated management of patient care.
Notifies Care Team Members of patient requests and need for referral and facilitates referrals as directed by PCP and Care Manager.
Facilitates the identification, recommendation, appropriate enrollment and registration of patients to Disease Management, High Risk programs, Pharmacy, patient transportation and other community-based assistance or other support programs based on PCP or Care Manager’s care decisions.
Assists in care delivery through the provision of scripted health education / monitoring and tuck-in calls.
Expedites completion of necessary forms and paperwork, confirms mailings, receipt of pertinent mailed materials, coordinates and tracks outstanding government / plan obligations and notifies appropriate Care Team members for follow ups.
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Performs additional duties as assigned.
One or two years of post-high school education or a degree from a two-year college.
Certified Medical Assistant (CMA) preferred.
Over 1 year and up to and including 3 years of experience in a healthcare setting.
Over 1 year of experience as a HCP Medical Assistant, Care Team Member 2, Patient Coach or Patient Liaison.
KNOWLEDGE, SKILLS, ABILITIES:
Computer literate (i.e. logging on to computer, usage of keyboard and mouse, familiarity with Windows and email applications).
Basic Microsoft Office skills.
Outstanding customer service skills.
Excellent verbal and written communication skills with ability to read, write, speak and understand English clearly.
Good critical thinking skills and resourcefulness.
Ability to problem-solve to effectively assist patient with issues and challenges.
Ability to transfer knowledge to patients with diverse cultural backgrounds while effectively coordinating their care.
Ability to effectively use organization’s health information technology resources in patient management.
Health literacy and cultural awareness skills.
Basic understanding of managed care principles.
Understanding of Medicare and MediCal / Medicaid benefits.
Ability to concurrently perform multiple tasks.
Bilingual in English and needed language (based upon demographic needs of panel).
What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM)
Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. OptumCare, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)
Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.