Job Summary The Care Navigator is responsible to assist the department in ongoing Healthcare Effectiveness Data and Information Set (HEDIS) collection and Quality Improvement Activities to close gaps in care for insurance companies, Innovation Care Partners (ICP) and other internal quality projects. This position includes ongoing quality improvement activities to assure the organization's quality programs with ICP are implemented and meet all requirements for successful quality metric reporting. For patients with gaps in care, the Care Coordinator Specialist will follow outreach protocols to make appointments for the patients as necessary.
Collaborates with onsite leadership, medical assistant and providers at each clinic for gap closure and to complete quality care goals. Assist clinical teams with proper documentation/requirements for quality requirements.
Participates in chart scrubbing, retrieval of medical records and data collection to support monthly and ongoing Innovation Care Partners (ICP) initiatives for quality improvement and to close outstanding care gaps.
Identify all patients with outstanding care gaps via roster from ICP or insurance payer. Pre-screen all scheduled patients via Electronic Medical Records (EMR) to identify opportunities to close gaps. Follow outreach protocols to schedule patients for necessary visits, labs, procedures, etc.
Analyze quality measures and identify opportunity trends for better patient health outcomes. Update health maintenance as indicated during chart auditing.
Ability to use multiple insurance and quality data bases with ICP to support successful Care Gap closure for patients.
Responsible for ongoing data submission to ICP and insurance payers.
Participate in monthly ICP meetings or webinars.
Performs other duties as assigned.
Internal Number: 2018-14239
Let’s transform healthcare together.
Every day, we bring patients convenient, coordinated access to healthcare while providing meaningful service to our community.
Join us and you will:
Develop professionally and achieve your career goals
Enrich your life with a focus on wellness
Enjoy a compassionate, caring culture with outreach to our local communities
Support the well-being of you and your family with a diverse portfolio of benefits
Welcome to HonorHealth.
We are a non-profit, local healthcare organization known for community service and outstanding medical quality. Our organization encompasses five acute care hospitals with approximately 10,500 employees and 3,100 volunteers, urgent care centers, clinical research, medical education, an inpatient rehabilitation hospital, an Accountable Care Organization, two foundations, and extensive community services.