- Coordinate and manage vendor operations to support member outreach activities. These activities include coordinating with various stakeholders, obtaining, and managing contracts, member data or outreach lists for implementation, monitoring performance, claim submissions and resolution, tracking activities, making recommendations, and evaluating results.
- Collaborate with internal/external partners and vendors on strategic planning for Quality initiatives, development, and implementation of programs, outreach initiatives and campaigns for members. Actively participate in meetings and/or workgroups, as assigned. Partner with Quality Improvement teams to provide insights and contribution of member feedback to improve member facing interventions and engagement.
- Manage vendor relationships and agreements. Support manager to provide ongoing communication, assist in monthly or quarterly performance meetings, responding to internal/external partner requests, member issues and inquiries to ensure meeting project objectives, timelines, budget, and goals defined.
- Provide culturally congruent outbound telephonic engagement calls and provide health education to members who meet criteria for population health programs, HEDIS, DHS withhold measures, and Star measures. Demonstrate a connection between building member relationships through engagement strategies by reaching members, providing health education, and setting up member appointments. Relationship building will also be demonstrated by supporting members social barriers to care and helping with referrals to address these needs.
- Document call outcomes in UCare's case management system, schedule medical appointments and necessary services, including support services for members in obtaining preventive care and services, considering the member's unique needs, and working to facilitate culturally congruent services whenever possible.
- Connect members to community resources congruent with their needs identified in the population health strategy or when conducting telephonic outreach. Collaborate internally or with members and/or family members, primary care physicians, clinic staff, providers, and other relevant agencies to assure appropriateness of services that meet member needs and ensure desired outcomes. Utilize UCare's social services engine to make referrals for members to address social needs.
- Utilize UCare systems to send member mailings regarding rewards, supplemental benefits, and/or appointment reminders in the mail. Support processes to update member information and communication preferences or enter members who wish to opt-out of further calls/mailings, etc.
- Responsible for management and prioritization of complex Health Improvement projects that may require collaboration with internal/external stakeholders and Subject Matter Experts (SMEs) to support Health Improvement programs. Activities may include coordinating schedules, updating tracking documents, allocating resources, communicating with partners, data analytics, leading and/or participating in related functions.
- Support the development and implementation of strategies to improve population health goals, HEDIS rates, DHS withhold measures, NCQA Accreditation Ratings, and CMS Star ratings.
- Maintain good working relationships and open communication with internal and external customers and stakeholders.
- Other projects and duties as assigned.
Health Improvement Coordinator - Minneapolis, United States - Ucare Minnesota
Description
ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission.
A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other.
Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began.
Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
Position Description
As a Health Improvement Coordinator, you will be responsible to organize the coordination and management of operations to support member outreach activities and manage vendor relationships for Quality programs including regulatory reporting, population health strategy, access to benefits, HEDIS rates, DHS withhold measures, NCQA Accreditation and Star measures for all products.
You will work closely with internal and external stakeholders to oversee the execution of programs, outreach initiatives and campaigns for members, as well as involve strategic planning and development for member engagement strategies in collaboration with the Quality teams.
You will also provide health education to members, including assistance with setting up medical appointments, transportation, interpreter services and related services in an effort to close gaps in care and increase access to benefits and resources.