Quality Coordinator
Roles &
Responsibilities:
- Receive incoming calls from members related to quality outreach initiatives.
- Make outgoing calls to educate members on closing care gaps and provide health education materials.
- Maintain accurate member records from outreaches and address member issues.
- Act as a liaison with providers, members, and community resources to assist with scheduling appointments and transfers.
- Ensure clear and complete information is provided to members in accordance with company guidelines.
- Refer members to Clinical Quality nurses as needed.
- Education Qualification:
- Associates degree in a healthcare field or 3 years of equivalent work experience. - 2 years of work experience in case management, community health, Medicaid, or health insurance.
- Minimum of 2 years of experience working with members to close care gaps.
- Required Skills:
- Knowledge of the Managed Care or Health Insurance Industry.
- Knowledge of medical terminology.
- Knowledge of PC's and windows-based software applications.
- Prefer knowledge of Medicaid and Medicare regulations.
- Excellent verbal and written communication skills.
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Estimated Salary: $20 to $28 per hour based on qualifications.
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