- Building relationships with providers and staff
- Through consistent phone calls and office visits (re: utilization information review, system training, customer service-related inquiries, sharing current and relevant information, etc.).
- Frequent travel to health center locations.
- Effect change and produce positive results for Cano Health centers to strengthen and support long term successful relationship.
- Overcome roadblocks and resistance to change through effective and consistent communication.
- Utilize systems to review pertinent utilization data and educate providers and provider's staff on utilization and correct application of best practices
- Understand and explain existing reports and provide new reports and tools, as needed.
- Provide system training to provider and staff.
- Work with Coding & Billing and HEDIS teams to ensure coding is being documented appropriately and HEDIS gaps are being closed.
- Develop strategies for improving all aspects of market performance including Medicare risk, HEDIS and medication management.
- Support provider and staff in closing MRA and HEDIS gaps
- Assist Cano Health in the oversight of membership growth strategies
- Identify membership trends
- Identify patients that may benefit from a Medicare Advantage Plan
- Communicate with business development team to provide support and data relevant to membership growth goals
- Compile performance metrics, bonus performances and review regularly with providers.
- Additional duties may be assigned by supervisor.
- No supervisory responsibilities
- Bachelor's degree in related field or equivalent work experience preferred
- 3-5 years of health care experience, preferably working with Medicare
- 1-2 years EMR/EHR system experience
- Ability to build and maintain relationships
- Ability to pay close attention to detail and to ensure accuracy of reports and data.
- Organization and time management skills
- Excellent written and verbal communication skills
- Skill in operating phones, personal computer, software, including Microsoft suite (Excel, Word and PowerPoint)
- Ability to communicate with employees, patients and other individuals in a professional and courteous manner.
- Fluent in English and Spanish
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Specialist, Provider Support - Hialeah, United States - Cano Health
Description
It's rewarding to be on a team of people that truly believe in making an impact
We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.
Job Summary
Provide utilization oversight, MRA and HEDIS support with a goal of helping physician offices to gain and maintain profitability for Cano Health medical centers and affiliated offices.
Essential Duties & Responsibilities
This position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Travel Requirements
Amount of Expected Travel
Details
Work will involve some driving/traveling to assigned clinics.
Disclaimer
The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
Join our team that is making a difference
Please see Cano Health's Notice of E-Verify Participation and the Right to Work post here
