Patient Care Advocate

Patient Care Advocate

This role is centered around enhancing the healthcare experience by working closely with members and providers to address care gaps, eliminate barriers, and improve overall satisfaction. The position involves outreach and face-to-face interaction with members and providers at large IPA or group practices. The role requires collaboration with field providers to enhance HEDIS measures and provide necessary education. Additionally, it supports quality improvement interventions and audits, ensuring compliance with State and Federal standards for HEDIS.

Responsibilities:

• Act as a liaison and advocate for members and their families, ensuring effective communication with physicians and healthcare facilities.
• Represent the organization positively within the provider community, maintaining an embedded presence within provider offices.
• Advise and educate provider practices on appropriate HEDIS measures and coding, adhering to NCQA standards.
• Assess provider performance data to identify and strategize opportunities for improvement.
• Collaborate with Provider Relations to enhance performance in Quality, Risk Adjustment, and Operations.
• Schedule necessary medical appointments for members to address care gaps within the provider's office.
• Provide face-to-face education to members and their families about identified care gaps and barriers to care during office visits.
• Conduct telephonic outreach and health coaching to support quality improvement and meet regulatory requirements.
• Arrange transportation and follow-up appointments for members as needed.
• Document all member-related actions and interactions diligently.
• Coordinate with other departments, such as customer service, to resolve member issues or refer to case management.
• Complete special assignments and projects that support departmental functions.
• Perform other duties as assigned in compliance with organizational policies.

Essential Skills:

• Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or a related field, or equivalent work experience (4 years).
• 2+ years of experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment.

Additional Skills & Qualifications:

• Preferred certifications: Licensed Practical Nurse (LPN), Licensed Master Social Worker, Certified Social Worker (C-SW), Licensed Social Worker (LSW), or Licensed Registered Nurse (RN).

Work Environment:

The position operates on a standard schedule from Monday to Friday, 8 a.m. to 5 p.m. EST, with no weekend, holiday, or overtime work required.

Job Type & Location:

This is a Contract position based out of Newark, DE.

Pay and Benefits:

The pay range for this position is $25.00 - $30.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type:

This is a fully remote position.

Application Deadline:

This position is anticipated to close on Sep 22, 2026.

About Actalent:

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.