Quality Engagement Specialist Job at Inland Empire Health Plans
Position Summary/Position
Under the direction of the Quality Improvement Leadership, the Quality Engagement Specialist is responsible for conducting Member outreach activities to encourage healthy behaviors including awareness of needed preventive care and chronic care services, ability to navigate healthcare systems, and awareness of available community resources to meet specific needs. This position will utilize clinical systems, care management platforms, and clinical registries utilized by IEHP and network Provider partners to identify Members needing outreach and support. The Quality Engagement Specialist will act as a support resource and liaison between IEHP and network Providers to engage Members in their healthcare. The Quality Engagement Specialist must effectively communicate assigned project scope, resources, and coordination status with key departments, external stakeholders, and various leadership levels. The Quality Engagement Specialist must be a proactive team player who works independently in external environments and who builds rapport with diverse Members, Providers, and local community partner agencies, with a focus of engaging Members into healthcare and improving their health. The Quality Engagement Specialist is responsible for supporting the Quality Improvement Department in the development, implementation, execution and monitoring of all quality initiatives, special projects, and committee deliverables as assigned. This role will require frequent travel within the Inland Empire. Major Functions (Duties and Responsibilities)
1. Conduct telephonic, virtual, or face-to-face Member outreach visits related to access and use of IEHP, Provider, and Community Partner programs and preventive care services, which encourage and empower Members to adopt health management and healthy lifestyle behaviors.
2. Perform outreach follow up (calls, texts, emails, letters, others) to ensure all Member needs have been met; outreach must follow department defined standard work (e.g., Where to identify Members that require outreach, following talking points/scripts during Member contacts, making the correct outreach attempts, connecting with Members’ Providers for appointment scheduling, identifying Social Determinants of Health needs and connecting to resources as needed, etc.).
3. Provide Member education on health topics including, but limited to utilizing the healthcare system, community-based organizations, accessing care, recommended preventive health screenings, and management of chronic conditions.
4. Serve as a dedicated resource to support Provider Network quality improvement projects supporting Member engagement with Primary Care health services which includes making outbound calls, scheduling appointments, and follow-up documentation, working collaboratively with Provider office staff and IEHP project team.
5. Act as liaison between Member, IEHP, Provider, and community partners to assist Member with appropriate and timely access to services.
6. Act as Member advocate on issues of social support, access to care and utilization of healthcare services and resources, as needed.
7. Ensure all case documentation, results record keeping, and evaluation tools are accurate and recorded timely.
8. Identify concerns related to Members’ access to care and communicate to Leadership as appropriate.
9. Demonstrate a commitment to incorporate LEAN principles into daily work.
10. Establish and maintain effective working relationships with all internal stakeholders and external Provider partners. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications
At least two (2) years of experience as a CHW, Promotora, or Health Navigator, or two (2) years of experience working in community outreach, customer service, or within a medical office, or a Behavioral Health or Substance Use Disorder program required. Preferred Experience Education Qualifications
High school diploma or GED required. Preferred Education Professional Certification Professional Licenses Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement
Knowledge of Medi-Cal managed care environment preferred. Understanding of and sensitivity to multi-cultural communities.
Skills Requirement
Requires critical thinking skills. Excellent written and verbal communication and interpersonal skills. Strong organizational skills. Demonstrated skills in successfully working with and engaging diverse teams. Excellent interpersonal/communication skills. Requires general knowledge of Microsoft Access, Word, and Excel.
Abilities Requirement
Able to sufficiently engage Members in a variety of settings, including on the phone, at Member’s homes, in hospitals and other settings. Ability to develop relationships with community Members and leaders, including in the faith-based community. A high degree of skillful decision making and judgement, in an autonomous position, including knowing when to consult with the team, supervisors, and experts. Able to develop effective relationships with Team Members, despite working primarily in the field. Ability to handle multiple projects, data input, strong problem-solving capability. Strong team player and proactive problem solver capable of accomplishing program goals. Must demonstrate mature professional skills in the areas of judgment and initiative to ensure a productive work environment and achievement of quality goals. Ability to maintain Member confidentiality. High degree of patience. Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Position requires frequent travel to off-site network Provider practices and community-based organizations. Performance of major duties will be carried out within off-site locations. Work Model Location Onsite Physical Requirements Hearing: One-on-One - CONSTANTLY Hearing: In a group - FREQUENTLY Hearing: Over the Telephone/Cell Phone - FREQUENTLY Communicate: Give instructions, advise, warn, instruct - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Communicate: Verbally engage with customer base - FREQUENTLY Near Visual Acuity - FREQUENTLY Perform complex and varied tasks - FREQUENTLY Develop and maintain positive work relationships - CONSTANTLY Adaptability: rate of change in work location - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Driving - FREQUENTLY Gross Manipulation - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Other - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: Traditional - FREQUENTLY Use of computer mouse - FREQUENTLY Alternate Sit/Stand or Walk at Will - FREQUENTLY Sitting - FREQUENTLY Indoors - FREQUENTLY Lighting - CONSTANTLY
A reasonable salary expectation is between $51,833.60 and $64,022.40, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Please Note :
ajayjain.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ajayjain.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
Under the direction of the Quality Improvement Leadership, the Quality Engagement Specialist is responsible for conducting Member outreach activities to encourage healthy behaviors including awareness of needed preventive care and chronic care services, ability to navigate healthcare systems, and awareness of available community resources to meet specific needs. This position will utilize clinical systems, care management platforms, and clinical registries utilized by IEHP and network Provider partners to identify Members needing outreach and support. The Quality Engagement Specialist will act as a support resource and liaison between IEHP and network Providers to engage Members in their healthcare. The Quality Engagement Specialist must effectively communicate assigned project scope, resources, and coordination status with key departments, external stakeholders, and various leadership levels. The Quality Engagement Specialist must be a proactive team player who works independently in external environments and who builds rapport with diverse Members, Providers, and local community partner agencies, with a focus of engaging Members into healthcare and improving their health. The Quality Engagement Specialist is responsible for supporting the Quality Improvement Department in the development, implementation, execution and monitoring of all quality initiatives, special projects, and committee deliverables as assigned. This role will require frequent travel within the Inland Empire. Major Functions (Duties and Responsibilities)
1. Conduct telephonic, virtual, or face-to-face Member outreach visits related to access and use of IEHP, Provider, and Community Partner programs and preventive care services, which encourage and empower Members to adopt health management and healthy lifestyle behaviors.
2. Perform outreach follow up (calls, texts, emails, letters, others) to ensure all Member needs have been met; outreach must follow department defined standard work (e.g., Where to identify Members that require outreach, following talking points/scripts during Member contacts, making the correct outreach attempts, connecting with Members’ Providers for appointment scheduling, identifying Social Determinants of Health needs and connecting to resources as needed, etc.).
3. Provide Member education on health topics including, but limited to utilizing the healthcare system, community-based organizations, accessing care, recommended preventive health screenings, and management of chronic conditions.
4. Serve as a dedicated resource to support Provider Network quality improvement projects supporting Member engagement with Primary Care health services which includes making outbound calls, scheduling appointments, and follow-up documentation, working collaboratively with Provider office staff and IEHP project team.
5. Act as liaison between Member, IEHP, Provider, and community partners to assist Member with appropriate and timely access to services.
6. Act as Member advocate on issues of social support, access to care and utilization of healthcare services and resources, as needed.
7. Ensure all case documentation, results record keeping, and evaluation tools are accurate and recorded timely.
8. Identify concerns related to Members’ access to care and communicate to Leadership as appropriate.
9. Demonstrate a commitment to incorporate LEAN principles into daily work.
10. Establish and maintain effective working relationships with all internal stakeholders and external Provider partners. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications
At least two (2) years of experience as a CHW, Promotora, or Health Navigator, or two (2) years of experience working in community outreach, customer service, or within a medical office, or a Behavioral Health or Substance Use Disorder program required. Preferred Experience Education Qualifications
High school diploma or GED required. Preferred Education Professional Certification Professional Licenses Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement
Knowledge of Medi-Cal managed care environment preferred. Understanding of and sensitivity to multi-cultural communities.
Skills Requirement
Requires critical thinking skills. Excellent written and verbal communication and interpersonal skills. Strong organizational skills. Demonstrated skills in successfully working with and engaging diverse teams. Excellent interpersonal/communication skills. Requires general knowledge of Microsoft Access, Word, and Excel.
Abilities Requirement
Able to sufficiently engage Members in a variety of settings, including on the phone, at Member’s homes, in hospitals and other settings. Ability to develop relationships with community Members and leaders, including in the faith-based community. A high degree of skillful decision making and judgement, in an autonomous position, including knowing when to consult with the team, supervisors, and experts. Able to develop effective relationships with Team Members, despite working primarily in the field. Ability to handle multiple projects, data input, strong problem-solving capability. Strong team player and proactive problem solver capable of accomplishing program goals. Must demonstrate mature professional skills in the areas of judgment and initiative to ensure a productive work environment and achievement of quality goals. Ability to maintain Member confidentiality. High degree of patience. Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Position requires frequent travel to off-site network Provider practices and community-based organizations. Performance of major duties will be carried out within off-site locations. Work Model Location Onsite Physical Requirements Hearing: One-on-One - CONSTANTLY Hearing: In a group - FREQUENTLY Hearing: Over the Telephone/Cell Phone - FREQUENTLY Communicate: Give instructions, advise, warn, instruct - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Communicate: Verbally engage with customer base - FREQUENTLY Near Visual Acuity - FREQUENTLY Perform complex and varied tasks - FREQUENTLY Develop and maintain positive work relationships - CONSTANTLY Adaptability: rate of change in work location - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Driving - FREQUENTLY Gross Manipulation - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Other - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: Traditional - FREQUENTLY Use of computer mouse - FREQUENTLY Alternate Sit/Stand or Walk at Will - FREQUENTLY Sitting - FREQUENTLY Indoors - FREQUENTLY Lighting - CONSTANTLY
A reasonable salary expectation is between $51,833.60 and $64,022.40, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Please Note :
ajayjain.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ajayjain.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.