Title: Patient Care Advocate
Location: Member Facing- Newark, DE (within 30 minutes driving distance between Newark and Wilmington, DE).  
Newark, Bear, New Castle, or Riverfront, DE
Duration:  5 months (possibility to extend)
Shift: 8 a.m. – 5 p.m.

Job Description:

• Works with members and providers to close care gaps, ensure barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction with members and providers at large IPA and/or group practices.

• Serves to collaborate with providers in the field, to improve HEDIS measures and provides education for HEDIS measures and coding.

• Supports the implementation of quality improvement interventions and audits in relation to plan providers.

• Assists in resolving deficiencies impacting plan compliance to meeting State and Federal standards for HEDIS.

• Conducts telephonic outreach, while embedded in the providers' offices, to members who are identified as needing preventive services in support of quality initiatives and regulatory/contractual requirements.

• Provides education to members regarding the care gaps they have when in the providers office for medical appointments.

• Schedules doctor appointments on behalf of the practitioner and assists member with wraparound services such as arranging transportation, connecting them with community-based resources and other affinity programs as available.

• Maintains confidentiality of business and protected health information.

Background & Context:

• This role will provide an opportunity for direct, face-to-face engagement with members and providers.

• It offers the opportunity to work onsite with providers to assist with engaging members and helping them navigate the healthcare system.

• Offers a unique role that bridges the gap between health plans and providers, improving communication and alignment.

• Embedding in provider offices creates a dynamic work environment

  Candidate Requirements
  Education/Certification	Required: Bachelor’s degree in healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field or equivalent work experience required (a total of 4 years of experience required for the position)			Preferred: Will take RN/LPN with 4 years’ experience in lieu of bachelor’s degree. (Can have Associate’s degree)
  Licensure	Required: RN, BSN, or LPN			Preferred: Licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN)
  Years of experience required Disqualifiers Best vs. average Performance indicators		Must haves: 4 years of experience in lieu of degree. RN or LPN with outpatient provider practice experience strongly preferred.   Nice to haves: Knowledge of HEDIS/Preventive screening recommendations   Disqualifiers: Not willing to travel/perform field work   Performance indicators: HEDIS care gap closure rates, HEDIS measure improvement, member outreach success rate, appointment scheduling rate, provider engagement/satisfaction
  Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection		1	Communication and Interpersonal Skills
  		2	Understanding of Provider Practice Scheduling
  		3	Problem Solving and Resource Coordination

 

 


At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $29.00/hr.