Quality Coordinator - Pennington, United States - Collabera

Description

Roles & Responsibilities:

• Receive incoming calls from members related to quality outreach initiatives.
• Make outgoing calls to educate members on closing care gaps and provide health education materials.
• Maintain accurate member records from outreaches and address member issues.
• Act as a liaison with providers, members, and community resources to assist with scheduling appointments and transfers.
• Ensure clear and complete information is provided to members in accordance with company guidelines.
• Refer members to Clinical Quality nurses as needed.
• Education Qualification: - Associates degree in a healthcare field or 3 years of equivalent work experience.
• 2 years of work experience in case management, community health, Medicaid, or health insurance.
• Minimum of 2 years of experience working with members to close care gaps.
• Required Skills:
• Knowledge of the Managed Care or Health Insurance Industry.
• Knowledge of medical terminology.
• Knowledge of PCs and windows-based software applications.
• Prefer knowledge of Medicaid and Medicare regulations.
• Excellent verbal and written communication skills.

There is available for relocation.