If you are a motivated and reliable person with exceptional customer service skills and the ability to thrive in a fast-paced environment, come join Holston Medical Group. We are looking for friendly, courteous employees to ensure a positive patient experience and welcome a teamwork environment.
Clinical Care Coordinator Summary:
The Clinical Care Coordinator will review the attributed Blue Cross Blue Shield Medicare Advantage and Humana Medicare Advantage patient list for any HEDIS gaps in care for the patient such as but not limited to diabetes, hypertension, and medication adherence. The Clinical Care Coordinator for Medicare Advantage Gap Closure will attest to measures which are documented within the patient’s medical record, will outreach to the patient to discuss/explain the gap (s) in care and schedule patient for appropriate follow-up appointments to meet the requirements to close the gap measure and to meet the gap criteria set forth by the insurance payer. The Clinical Care Coordinator will review payer scorecard (s) and work with Operations Management Team to obtain an overall 5 STAR Rating for the group.
Clinical Care Coordinator Pay & Benefits:
- Competitive Pay Based on Experience
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
- Short Term Disability
- Long Term Disability
- Life Insurance
Clinical Care Coordinator Qualifications:
- Minimum High School diploma or equivalent required
- LPN licensed by the state in which employed or Registered/Certified Medical Assistant
- Ability to work independently with strict adherence to protocols in an accountable manner
- Empathetic and patient
- Excellent communication skills both written and oral
- Superb time-management, organizational and problem-solving skills
- EMR and scheduling proficiency
- Knowledge of HEDIS Gap Measures
Clinical Care Coordinator Responsibilities:
- Establish close relationships with patients that will increase compliance with treatment recommendations and patient management plans.
- Maintain communication with providers and collaborate care with patient.
- Maintain strict confidentiality in all matters relating to patient PHI (Protected Health Information).
- Review data within the patient chart which can be used to attest for a HEDIS measure and outreach to the patient for review/discussion of the specific gaps in care.
- Coordinate and schedule appointments for patients to address specific gaps in care.
- Review payer scorecard and work with Operations Management Team to improve overall STAR rating for the group.
- Ensure appropriate documentation/results are listed within the EHR; complete manual reporting within the payer’s system of patient results/data.
- Review payer scorecard for patient gaps in care
Job Type: Full-time
Schedule:
People with a criminal record are encouraged to apply
License/Certification:
- LPN license (Preferred)
- CCMA Certification (Preferred)
Ability to Commute:
- Kingsport, TN 37660 (Required)
Work Location: In person