Quality Specialist - Hybrid

Quality Specialist

As a Quality Specialist, you will be responsible for performing outbound patient calls regarding our clinical programs, medication adherence, and closing gaps in care for value-based contracted patients with clinical quality needs. The role will partner closely with our quality, population health, and pharmacy teams to effectively deliver wrap-around care for our patients. The ideal candidate will have the ability to work in a fast-paced environment while using excellent communication skills to serve our patients. They must be proactive with a strong personal initiative, as well as highly organized and detail oriented.

How You Will Get Things Done:

• Call patients to ensure they refill their chronic disease medications on time for diabetes, blood pressure, and cholesterol
• Serve as liaison between patient, clinic, and pharmacy to minimize time missed between refills
• Interpret patient medical history (medication list, office visit notes, etc.) and understand and properly communicate provider's plan to patient
• Navigate between different Electronic Medical Record (EMR) platforms to review patient medical information
• Accurately and comprehensively document patient care activities in all applicable electronic records
• Perform appropriate medication reconciliation by comparing how your patient is taking medication versus what is written in medical record and/or filled at the pharmacy
• Request medication refills per clinic policy and protocol
• Adequately assist patients with difficulties accessing medication due to cost or other barriers
• Identify patients who need referrals to clinical pharmacist, retail pharmacy med sync program, retail pharmacy medication pack program, care management, clinician, and/or Village at Home
• Timely follow up and persistent outreach to patients, providers, and pharmacies to ensure medications are picked up and taken as directed
• Connect with patients before and after their primary care visit, if necessary, to help coordinate the completion of their quality health maintenance
• Schedule appointments and testing and/or order screenings per standardized protocols
• Maintain current knowledge of quality measure requirements
• Scheduling patient appointments as needed for refills/barriers
• Assisting other quality departments as needed per quarter

How You Will Build Trust:

• Demonstrate kindness and compassion in all patient interactions
• Actively participate as a member of the health care team to promote positive health outcomes for our patients and support our healthcare partners
• Participating in team building exercises/tools
• Coordinate with pharmacy staff, primary care office staff and/or providers to ensure appropriate referrals, orders, and tests are in place for the patient

How You Will Innovate:

• Contribute to increasing overall quality ratings for clinic by ensuring patients refill and take their medication on time and as directed
• Identify opportunities for continuous process improvement

EXPERIENCE TO DRIVE CHANGE

• High school diploma or GED equivalent required
• Certified Medical Assistant, Certified Pharmacy Technician, or equivalent experience in a healthcare setting required
• Intermediate to advanced level keyboarding skills (at least 35 WPM, touch typing, formatting documents) required
• Work from home environment:
• Secure workspace at home, including desk and chair, with minimum background noise required
• Candidate supplied home internet access required
• Minimum internet download speed of 100mbps and upload speed of 10mbps required
• Internet to be hard-wired with an ethernet cord required. Wi-Fi connection cannot be used.
• 1+ years of experience in a healthcare setting preferred
• Prior experience using an Electronic Health Record (EHR) preferred
• Previous call center or telephonic experience preferred
• Experience with Medicare Advantage plans, insurance, and medication adherence preferred
• Bilingual English/Spanish preferred