Healthcare Improvement Quality Outreach Consultant

Job not on LinkedIn

🔥 9 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $22 - $37 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 36 days.

Apply Now

Find Similar Remote Jobs

LTHC

WebsiteLinkedInAll Job Openings

2 - 10 employees

Founded 2016

🧘 Wellness

⚽ Sports

👥 B2C

Wellness • Sports • B2C

LTHC é a empresa que detém a Academia LIFT e pretende adquirir ou desenvolver outros espaços no mesmo âmbito. Foca‑se na experiência do cliente — conforto, interação com o espaço e objetivos pessoais — para atletas, praticantes ocasionais e profissionais, apoiando metas de bem‑estar físico, psicológico e desempenho competitivo. Opera como um espaço de fitness/treino com ênfase em culturismo, exercício e saúde.

📋 Description

• Identify members with gaps in care using multiple information sources, HEDIS quality measures, and Value Base Payment programs • Assess member needs using Health Plan-approved guidelines and assessment tools • Provide telephone and written outreach and education regarding healthcare quality metrics • Assess barriers to care and facilitate access, referrals, and interventions • Establish relationships with providers and community agencies • Advocate for members and address social determinants of health • Collaborate with hospital executives and physician leadership on quality measures and outcomes • Present and promote clinical programs to provider offices and educate providers and community agencies • Pilot and collect data on methods to promote quality health outcomes • Serve as a resource to healthcare improvement project teams and lead project teams as a subject matter expert • Manage caseloads and maintain documentation according to health plan standards • Meet departmental metrics including call volumes, reach rate, and gap closure rate • Facilitate adherence to provider Service Level Agreements • Adhere to compliance, regulatory, privacy, and corporate conduct standards • Level II: Prioritize work and guide, train, and mentor junior staff • Level II: Manage key provider practices and serve as point person in the Supervisor’s absence • Level II: Collaborate across departments to improve processes and systems • Level II: Review metrics and apply continuous quality improvement principles • Level II: Follow the PDSA model, review practice outcomes, identify best practices, and recommend improvements • Level II: Research best practices across health plans and healthcare improvement trends • Level II: Assist with developing and implementing innovative care management pilots and quality programs

🎯 Requirements

• Minimum of three (3) years’ experience in health/human services • Associate degree in human services or business-related field, or a minimum of four years direct provider and member contact in lieu of degree • Bachelor’s degree preferred • LPN or Medical Assistant preferred • Experience with project management • Experience working with member populations from one or more lines of business (Commercial, SafetyNet, Medicare) • Experience giving formal/informal presentations to small/large audiences • Proficiency in MS Office programs: Word, Excel, PowerPoint • Self-motivated and able to work independently as well as on matrixed teams • Ability to problem solve for effective conflict resolution • Experience with iFacets claims processing and coding preferred • Knowledge of preventive health activities and community agencies preferred • Level II: Minimum of five (5) years direct experience with the provider and member community • Level II: Excellent communication and presentation skills • Level II: Experience working with member populations from all lines of business (Commercial, SafetyNet, Medicare) • Level II: Subject Matter Expert in HEDIS and VBP quality measures • Level II: Experience and proven success with PDSA process improvement cycle • Level II: Demonstrated skills in quality principles, especially root cause analysis and problem solving • Level II: Knowledge of health insurance industry, federal and state regulations, accreditation standards, and quality improvement organizations including NCQA, CMS, The Joint Commission, and NYS DOH • Level II: Demonstrated leadership skills • Ability to travel across the health plan service regions as needed

🏖️ Benefits

• Group health and/or dental insurance • Retirement plan • Wellness program • Paid time away from work • Paid holidays • Potential remote work, determined case-by-case • Employee development • Competitive compensation • Workforce diversity and innovative thinking culture

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume