Mosaic CIN connects physicians, hospital systems, and community leaders to deliver seamless, value-based care tailored to the unique needs of each community. Our network includes Henry Ford Medical Group, Henry Ford Allegiance Medical Group, MSU Health Care, and a diverse range of independent practices of all sizes. To learn more, click here
This position is a hybrid work format and will require at least one day a week in office in Detroit, Plymouth, or Jackson.
GENERAL SUMMARY:
Under the direction of leadership, the Patient Outreach Improvement Specialist supports patient engagement, membership alignment, and documentation improvement initiatives across value-based care programs. The Specialist focuses on executing outreach strategies to re-engage patients, reconciling payor membership data, and supporting accurate and compliant medical record documentation within Epic. The Specialist works closely with providers, practices, and internal teams to improve patient access to primary care, enhance panel attribution accuracy, and promote best practices in documentation to support risk adjustment, quality reporting, and regulatory compliance.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
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Identify patients without a primary care visit in the past 12 months and execute outreach strategies to re-engage patients with their Primary Care Provider (PCP).
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Conduct outreach through multiple channels (e.g., phone, electronic, and practice coordination) and track engagement outcomes.
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Review and work payor membership lists to validate and reconcile patient attribution and alignment.
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Identify and escalate discrepancies impacting panel accuracy and coordinate resolution with internal teams and external payor partners.
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Review medical record documentation to identify gaps impacting HCC capture, coding accuracy, and compliance.
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Support practices in improving documentation workflows and adherence to regulatory requirements.
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Utilize Epic to evaluate documentation workflows, support care gap closure, and ensure accurate record maintenance.
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Document standard workflows and develop process guides to support consistent documentation practices.
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Partner with practices to provide training and guidance on documentation best practices and Epic workflows.
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Support onboarding and education related to documentation improvement initiatives.
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Track outreach activities, alignment efforts, and improvements in documentation; maintain accurate data for reporting.
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Participate in process improvement initiatives to enhance outreach effectiveness, data accuracy, and workflow efficiency.
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Perform other duties as needed.
EDUCATION/EXPERIENCE REQUIRED:
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Associate’s degree in healthcare administration, health information management, business, or related. Bachelor’s degree preferred.
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Three (3) years of experience in healthcare operations, outreach, care coordination, coding, billing, or related field.
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Experience working within an Electronic Medical Record (EMR), Epic strongly preferred.
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Experience supporting patient outreach, membership alignment, or population health initiatives preferred.
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Experience in value-based care, managed care, or population health programs preferred.
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Background in coding, billing, or clinical documentation improvement (CDI) preferred.
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Working knowledge of medical record documentation requirements, coding practices, and billing workflows.
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Understanding of Hierarchical Condition Categories (HCC) and their impact on risk adjustment and reimbursement.
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Strong organizational skills with the ability to manage multiple priorities and deadlines.
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Effective problem-solving and critical thinking abilities.
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Strong interpersonal and communication skills with the ability to work across multidisciplinary teams.
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Proficiency in Microsoft Office applications (Excel, Word, Outlook).
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Ability to maintain confidentiality and adhere to HIPAA and regulatory requirements.
CERTIFICATIONS/LICENSURES REQUIRED:
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Relevant certification (e.g., CPC, CCS, RHIT) preferred.
Additional Information
- Organization: Corporate Services
- Department: HF CIN
- Shift: Day Job
- Union Code: Not Applicable
