Quality Specialist
Houston, TX - USA
Job Summary
Were a physician-led patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary multispecialty and urgent care providers serve millions of patients in traditional practices patients homes and virtually through VillageMD and our operating companies Village Medical Village Medical at Home Summit Health CityMD and Starling Physicians.
When you join our team you become part of a compassionate community of people who work hard every day to make health care better for are innovating value-based care and leveraging integrated applications population insights and staffing expertise to ensure all patients have access to high-quality connected care services that provide better outcomes at a reduced total cost of care.
Please Note: We will only contact candidates regarding your applications from one of the following domains: @ @ @ @ @ @ or @.
As a Quality Specialist you will be responsible for performing outbound patient calls regarding our clinical programs medication adherence and closing gaps in care for value-based contracted patients with clinical quality needs. The role will partner closely with our quality population health and pharmacy teams to effectively deliver wrap-around care for our patients. The ideal candidate will have the ability to work in a fast-paced environment while using excellent communication skills to serve our patients. They must be proactive with a strong personal initiative as well as highly organized and detail oriented.
How You Will Get Things Done:
Call patients to ensure they refill their chronic disease medications on time for diabetes blood pressure and cholesterol
Serve as liaison between patient clinic and pharmacy to minimize time missed between refills
Interpret patient medical history (medication list office visit notes etc.) and understand and properly communicate providers plan to patient
Navigate between different Electronic Medical Record (EMR) platforms to review patient medical information
Accurately and comprehensively document patient care activities in all applicable electronic records
Perform appropriate medication reconciliation by comparing how your patient is taking medication versus what is written in medical record and/or filled at the pharmacy
Request medication refills per clinic policy and protocol
Adequately assist patients with difficulties accessing medication due to cost or other barriers
Identify patients who need referrals to clinical pharmacist retail pharmacy med sync program retail pharmacy medication pack program care management clinician and/or Village at Home
Timely follow up and persistent outreach to patients providers and pharmacies to ensure medications are picked up and taken as directed
Connect with patients before and after their primary care visit if necessary to help coordinate the completion of their quality health maintenance
Schedule appointments and testing and/or order screenings per standardized protocols
Maintain current knowledge of quality measure requirements
Scheduling patient appointments as needed for refills/barriers
Assisting other quality departments as needed per quarter
How You Will Build Trust:
Demonstrate kindness and compassion in all patient interactions
Actively participate as a member of the health care team to promote positive health outcomes for our patients and support our healthcare partners
Participating in team building exercises/tools
Coordinate with pharmacy staff primary care office staff and/or providers to ensure appropriate referrals orders and tests are in place for the patient
How You Will Innovate:
Contribute to increasing overall quality ratings for clinic by ensuring patients refill and take their medication on time and as directed
Identify opportunities for continuous process improvement
EXPERIENCE TO DRIVE CHANGE
High school diploma or GED equivalent required
Certified Medical Assistant Certified Pharmacy Technician or equivalent experience in a healthcare setting required
Intermediate to advanced level keyboarding skills (at least 35 WPM touch typing formatting documents) required
Work from home environment:
Secure workspace at home including desk and chair with minimum background noiserequired
Candidate supplied home internet access required
Minimum internet download speed of 100mbps and upload speed of 10mbps required
Internet to be hard-wired with an ethernet cord required. Wi-Fi connection cannot be used.
1 years of experience in a healthcare setting preferred
Prior experience using an Electronic Health Record (EHR) preferred
Previous call center or telephonic experience preferred
Experience with Medicare Advantage plans insurance and medication adherence preferred
Bilingual English/Spanish preferred
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMDs benefit platform includes Medical Dental Life Disability Vision FSA coverages and a 401k savings plan.
Our Companyprovides equal employment opportunities (EEO) to all employees and applicants for employment without regard to and does not discriminate on the basis of race color religion creed gender/sex sexual orientation gender identity and expression (including transgender status) national origin ancestry citizenship status age disability genetic information marital status pregnancy military status veteran status or any other characteristic protected by applicable federal state and local laws.
OurCompanycares about the safety of our employees and Companydoes not use chat rooms for job searches or Companywill never request personal information via informal chat platforms or unsecure Companywill never ask for money or an exchange of money banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at selectOur Companylocations during regular business hours only. For information on job scams visit file a complaint at Experience:
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About Company
Summit Health has more than 2,500 providers, 12,000 employees, and over 340 locations in New Jersey, New York, Connecticut, Pennsylvania, and Central Oregon. Determine your health needs and choose the provider that best fits your needs.