Quality Outreach Specialist

Your Role

The Quality Outreach Specialist will be a key part of improving Star Ratings and the ACO REACH quality programs by removing barriers to achieving high quality health outcomes. As the Quality Outreach Specialist, you will identify and remove patient barriers to accessing and receiving care, like patient medication adherence outreach, connecting patients with care providers and available services, and medical record review to identify gaps in care. Additionally, you will work with the quality team to develop initiatives and educational materials for our providers, patients, and internal market teams.   

Primary Functions of the Quality Outreach Specialist Include:

• Patient outreach calls to understand root causes of barriers to medication non-adherence and offer solutions
• Patient outreach calls to connect patients with important care and services to close critical gaps in care
• Follow up with patients’ care team on findings from patient conversations, when necessary.
• Complete medical record reviews to find evidence of clinical gap in care closure
• Prepare and submit gap in care closure details to the payor and joint venture partners.
• Provision of subject matter expertise on educational tools and learning sessions development.
• Identify learning opportunities for practices and providers based on medical record review, outreach call, and other initiative outcomes.
• Support the development of initiatives to support patient care and gap in care closure.
• Support the creation and review of educational materials and learning sessions for external provider partners on themes and findings from outreach programs and initiatives.
• Perform other related responsibilities as assigned.

How You Qualify

You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities. 

• Medical Assistant, Licensed Practical Nurse, Certified Nursing Assistant, , Emergency Medical Technician, Pharmacy Technician license or certification required
• Bachelor’s/ Undergraduate degree preferred
• 3+ years of experience in a role for which closing Healthcare Effectiveness Data and Information Set (HEDIS) measures and/or Star Rating gaps were primary responsibilities
• Prior quality measure chart review experience
• Experience complying with Health Insurance Portability and Accountability Act (HIPAA)
• Inpatient or outpatient clinical experience, including strong electronic medical records (EMR) experience preferred
• Ability to manage deadlines and handle multiple tasks simultaneously
• Detail orientated, organized and self-motivated
• Ability to handle sensitive and/or confidential material and information appropriately
• Strong verbal and written communication skills
• Ability to work with large files and data sets
• Proficient in Microsoft Office Suite : PowerPoint for presentations, Excel for mathematical formulas, charts, tables; Word and Outlook for communication to patients, healthcare insurance companies and internal company personnel

The base pay range for this role is $25.72 - $28.89. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, and organizational needs. Base pay is just one piece of the total rewards program offered by Honest. Eligible roles also qualify for short-term incentives and a comprehensive benefits package.