This is a permanent work from home opportunity.
The HEDIS Outreach Coordinator within the Healthy
Outcomes Team conducts outreaches to our Medicare
members to inspire and encourage healthy behaviors
through innovative, compassionate and empathetic
telephonic communications. The goal of each outreach is
to ensure that every member has a clear understanding of
the available benefits that are afforded to them under their
Medicare plan. The Healthy Outcomes Coordinator facilitates Provider and Member outreaches telephonically to ensure Medicare member receipt of important clinical tests and services to improve Star health outcomes.
They provide support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives by performing the following:
- Outreach to members who don't have a record of the
designated services or vaccination, effective capture of barriers and data collection, use of motivational interviewing skills to provide solutions in order to meet the gap in care, and providing best in class support to each member.
- Ensures that every customer is treated professionally,
with respect and all questions are thoroughly answered
and/or triaged and responded to.
- Acts as an advocate for our Medicare members
preventive health and vaccination needs.
- Collect effective data elements in the CRM tool to support medical record chasing for HEDIS medical record
documentation and services.
-Minimum 3 years recent and related experience within
healthcare, healthcare marketing, outreach and/or health
education, health coaching and disease management
-3 – 5 years of experience in a healthcare setting with
direct communication with various levels of management
including medical providers required.
-Effective communication skills and experience speaking
with medical providers and/or clinical staff.
-Ability to apply creative thinking skills when needed to solve members' concerns and have a desire to advocate for them.
-Ability to thrive on change, to adapt to multiple focuses in short amounts of time.
-Demonstrated ability to de-escalate situations.
-Ability to work independently, apply critical thinking skills when needed, multitask with ease, and demonstrate professionalism in all interactions.
-Demonstrated empathy, compassion and listening skills.
-Windows based application knowledge with ability to use standard corporate software packages and corporate applications with a high degree of computer literacy.
-Recent and related experience working with HEDIS screening measures and/disease management, behavior change.
-Bilingual or multilingual candidates heavily preferred.
-Bachelor's degree or equivalent heavily preferred.
-Medical certification (certified nursing assistant, medical assistant, etc.) is strongly recommended but not required.
-High School diploma, G.E.D. or equivalent experience
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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