Job Duties
Under the supervision of RN Care Coordinator Manager, Primary Care performs tasks and patient contact to assist in the coordination of patient primary care services. Services include obtaining and running reports to assist with review and resolution of care gaps, improvement of Health Maintenance and HEDIS scores, transition of care from inpatient and Emergency care and other service settings.
Essential Functions
- Reviews monthly Care Gap data from the Managed Care Department for Family Medicine and General Medicine clinics.
- Obtains and reviews daily ED visits reports to assist with identification of high ED utilizers.
- Contacts insurance Case Managers under the direction of the RN Care Coordinator Manager, and implements plans to follow up with patients, to include phone calls, video discussions to assist in preventing or reducing ED visits.
- Reviews Healthy Planet Performance of each clinic monthly and identifies measures that require improvement, and communicates to RN Care Coordinator Manager.
- Responsible for compliance with Health Maintenance and Centers for Medicare & Medicaid Services (CMS) guidelines..
- Assists with distribution of reports to individual clinics.
- Answer questions, assist with problems, and ensure goals, standards, and deadlines are met.
- Assists with maintenance of database and relationship with community resource providers.
- Maintain a positive customer service oriented disposition toward all clients and co-workers. Provide excellent customer service with internal and external customers.
- Prepares and maintains all clerical aspects of the medical records through established guidelines.
Temperament
Must be able to perform under stress when confronted with emergency, critical, or unusual situations. Must be capable of dealing with periodic cyclical workload pressures and levels of responsibility. Required to make independent judgments without supervision. Must be able to make generalizations, evaluations, or decisions based on sensory or judgmental criteria. Must have the adaptability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure. Requires the ability to work with people beyond giving and receiving instructions.
Skills, Knowledge, Abilities
- Ability to organize and prioritize assignments to work independently as well as a collaborative team member.
- Basic computer literacy and arithmetic skills.
- Knowledge of ambulatory health care or related health care field.
- Ability to provide dynamic customer service using various techniques including positive language, calming presence, attentiveness, clear communication, and patience.
- Possesses critical thinking, prioritization, and organizational skills.
- Attention to detail and quality of work.
- Ability to communicate effectively and courteously, both orally and in writing.
Experience Requirements
1 year Medical assistant preferred
2 years Clerical/customer service experience -ideally in a health care related industry preferred
1 year One year experience with third party payors and computer experience for in
putting data and reviewing patient demographic material preferred
Education Requirements
High School Diploma or GED required
Certification/Licensure
Certified Medical Assistant (CMA) required within 6 months
Basic Life Support (BLS) required at time of hire
Medical Terminology Certificate preferred at time of hire
UFJPI is an Equal Opportunity Employer
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- 403(b)
- 403(b) matching
- AD&D insurance
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Loan forgiveness
- On-the-job training
- Opportunities for advancement
- Paid sick time
- Paid time off
- Paid training
- Pet insurance
- Professional development assistance
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
- Wellness program
Schedule:
Work setting:
Ability to Relocate:
- Jacksonville, FL 32218: Relocate before starting work (Required)
Work Location: In person