STAR Coordinator - CenterWell - Houston TX

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Job Information
Humana
STAR Coordinator - CenterWell - Houston, TX
in
Houston
Texas
Description
We are excited to share that we are in the process of changing our name to CenterWell Senior Primary Care. We expect our name transition to be complete by the first part of April 2021. We feel our new name will better reflect our commitment to deliver senior-focused primary care and reinforces our commitment to putting patients at the center of what we do every single day. The new name truly captures how we support senior health and wellness from every angle - physical, emotional and social. Join a team committed to making seniors healthier and happier every day by putting them at the center of everything we do.
The HEDIS/STAR Outreach Coordinator facilitates Provider and Member outreaches telephonically, virtually or in person to ensure Medicare member receipt of important clinical tests and services to improve Star health outcomes.
Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives by performing the following:
Regular review of reports to identify patients with gaps in care, submitting necessary documentation to health plans to close gaps, and medical chart review to validate patients for proactive outreach and scheduling of services
Outreach to members who don't have a record of the designated services, effective capture of barriers and data collection, use of motivational interviewing skills to provide solutions in order to close the gap in care, and providing best in class support to each patient.
Ensures that every patient is treated professionally, with respect and all questions are thoroughly answered and/or triaged and responded to.
Responsibilities
As directed, utilizes payer and internal analytic reports to identify HEDIS and Quality gap opportunities for closure and follows internal workflows and procedures to close gaps. Initiates outbound calls to members and external providers to collect information and provide care coordination assistance in obtaining services (e.g. schedule appointments, provider appointment reminders, coordinate transportation, etc.) to avoid delays in treatment and improve member health outcomes and Medicare HEDIS Star measures. Collect effective data elements to support medical record chasing for HEDIS medical record documentation and services and submit documentation to the payers if gap can be closed (e.g. blood pressure values, A1c values, colorectal cancer screening reports, breast cancer screening reports, etc.). Update the electronic health record/CDSS for accuracy. Participates in Health plan quality meetings. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Documents member participation in outreach activities in accordance with organizational standards and distributes educational information to patient and providers and closes the loop on the patient gap in care. Maintains database to track member compliance. Identifies when to refer member to additional internal or external resources for further intervention.
Assists in the development and standardization of outreach talking points, scripting and data collection tool to improve HEDIS data collection and service documentation. Identifies opportunities to partner with other Partners in Primary Care/Centerwell staff and resources, community organizations and internal stakeholders on process improvements, special projects, health events, and presentations (i.e., health fairs, community events and member meetings). Performs other duties as required.
Required Qualifications
High School Diploma
Bilingual, fluent in English/Spanish without any assistance
One-year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience.
1 - 3 years of administrative, operations support or customer service experience
Minimum 2 years recent and related experience within healthcare, healthcare marketing, outreach and/or health education, health coaching and disease management experience required.
Medical Assistant Certification from AMT, AAMA, NCCT, NHA required.
Effective communication skills and experience speaking with medical providers and/or clinical staff.
Recent and related experience working with HEDIS screening measures and/disease management,
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.
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.
​Availability to travel to different offices
Proficiency with Microsoft Word, Excel, etc.
Strong oral and written communications skills
Ability to meet deadlines in a fast-paced environment
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Bachelor Degree
Experience in HEDIS
Additional Information
Interview Format:
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will read to a set of interview questions and you will enter/text responses to each question. You should anticipate this interview to take about 10 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Alert:
Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website.
Scheduled Weekly Hours
40

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