COMMUNITY WELLNESS ADVOCATE - HOAG CLINIC QUALITY IMPROVEMEN

Employment Type

: Full-Time

Industry

: Miscellaneous



Job Summary:  The Community Wellness Advocate is a member of the Quality Improvement team who is responsible for coordinating with all Hoag Clinic’s Senior members their necessary annual visits and available services to ensure compliance in quality and risk adjustment programs.  The Community Wellness Advocate will be responsible for the daily management of our senior patient population by coordinating delivery of quality services through appropriate appointment setting and managing needed quality care gaps.   The Community Wellness Advocate displays and practices a work-style that reflects the mission, vision and values of the Hoag Hospital. Participates in the continuous Quality Improvement process, maintains a working knowledge of departmental standard operating procedures.   Essential Functions * Promotes routine visits with primary care physician and ensures that patients are set up for a successful health maintenance year through their necessary annual wellness and follow up visits. * Must practice excellent communication skills; customer focused; excellent attention to detail; able to prioritize tasks and meet deadlines; strong interpersonal skills; able to work in a team environment. * Will participate in a collaborate effort to create and continuously improve senior outreach strategy to meet the needs of the patient population and departmental goals. * Contacts new and currently enrolled senior patients and assists patient with scheduling all necessary annual appointments as well as reviewing overdue quality care gaps using standardized scripts. * Schedules appointments (new and return) and in addition to facilitates the process of scheduling ancillary test/screenings. Is responsible for new senior patient coordination. * Maintains clinical competency requirements within scope of practice. Demonstrates initiative for self-improvement and completes required competencies. * Participates as a team member and communicates effectively with the health care team. * Reviews and works in collaboration with Hoag Clinic pharmacy team in order to close gaps in Medication Adherence measures. Is able to review and analyze patient’s medication needs to increase medication compliance. * Participates in staff meetings and other interdisciplinary meetings. * Demonstrates excellent communication skills. Communicates with patient/family in a clear, concise and understandable manner. Obtains confirmation that information given to patient/family was understood. * Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. * Demonstrates knowledge and use of ICD-10 coding. * Will be responsible for coordinating mailings of welcoming packages, needed materials/forms, and thank you letters. * Under the guidance of the Quality Improvement leadership, coordinates special projects aimed at closing quality care gap reports specific assigned site(s). * Analyzes the monthly patient care gap report per provider at each designated site(s) to contact patients on list by phone, letter, or electronically to remind patients of their visits, health screenings or tests due. * Close care gaps. Interaction with patients is documented in Electronic Medical Record (EMR) system. * Review patient chart in EMR for any tests or screenings completed within the quality measure guidelines. Will search in other systems within EMR and hospital EMR to locate any record(s) that demonstrate completion of screening or testing. * Review patient’s previous history and referrals that may indicate that tests or screenings have been completed by provider outside of network. Will work on contacting network provider(s), obtain a medical release from patient, to retrieve the necessary records form provider(s) outside of network. * Coordinates communication and transactions between patient, ancillary services, consultants, and physicians.   Education, Training and Experience   Required:  * High school graduate or equivalent * Minimum two (2) year previous medical back-office experience in healthcare system environment * Experience in front-office experience in healthcare system environment Preferred: * Graduate of Medical Assistant program * Associate or Bachelor’s degree in healthcare-related field   Skills or Other Qualifications   Required: * Excellent communication skills; customer focused; excellent attention to detail; able to prioritize tasks and meet deadlines; strong interpersonal skills; able to work in a team environment. * Basic keyboarding skills at 35 WPM. * Basic knowledge of Microsoft Office Suite, including Outlook, Word and Excel. * Proven ability to interface with all customer levels (physicians, Organizational staff, insurance companies, patients and family members). * Basic knowledge of medical terminology   Preferred: * Qualified bilingual or multilingual candidates   License and Certifications   Required:  * Certification as a Medical Assistant by an accredited program * BLS certification   Preferred: * Certification as a Licensed Vocational Nurse by an accredited program

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