Job Details
Conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols Interact with patients via telephone; Schedule appointments, Follow up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed Provides care coordination/case management through physician practices for members to improve clinical quality and clinical documentation. No direct patient care Review member charts prior to a physician appointment and create alerts/triggers to highlight Star opportunities for the practice Partner with the practice's administrative and clinical staff while managing patient appointments and data between visits Create and maintain a professional and supportive relationship with the patient, provider and office staff? Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services Assists the member to access communit...RN, Practice, Performance, Consultant, Remote, Clinical, Healthcare