Care & Population Health Management Specialist
Department: Care & Population Health Management
Reports To: Special Needs Plan Care Coordination Manager
Status: Full Time, Non-Exempt
Hours: Monday – Friday
Supervision: This position does not supervise any other staff
Date Updated: March 20, 2023
Summary: This position is responsible for assisting the Director of Care & Population Health Management, the Special Needs Plan Care Coordination Manager, and other Care & Population Health Management staff ensure the smooth and efficient functioning of the department. The Care & Population Health Management Specialist will assist callers (including members), be proactive in assisting staff, ensure that department services and supplies are handled efficiently, and keep the department environment clean and neat.
Reporting Accountability This position is responsible for meeting the following regulatory, contractual, or other requirements on behalf of PrimeWest Health:
- Comply with Centers for Medicare & Medicaid Services (CMS)/Minnesota Department of Human Services (DHS) contracts Ensure compliance with applicable regulatory and contractual requirements related to the Care & Population Health Management department
- Maintain knowledge of National Committee for Quality Assurance (NCQA) requirements
Role and Key Responsibilities
Assist the Director of Care & Population Health Management, the Special Needs Plan Care Coordination Manager, and other PrimeWest Health staff in the following as needed:
- Report and Application Submission
- Assist in making copies, faxing documents, constructing letters/documents, and preparing mailings
- Enter data related to care coordination activities into the Medicaid Management Information System (MMIS)
- Coordinate Jiras for new reporting and/or communications requests
- Coordinate CE Direct questions, run reports, and maintain user profiles
- Meetings
- Schedule and arrange meetings including reserving rooms and catering when applicable
- Coordinate development of meeting agendas
- Record meeting minutes as requested by Care & Population Health Management staff
- Other
- Coordinate county case management educational events, trainings, newsletters, and webinars
- Create, update, and post Care & Population Health Management workflows to Confluence
- Assist department with NCQA accreditation, the CMS Model of Care (MOC) audit, and the request for proposal (RFP) response process
- Maintain the Care & Population Health Management page on Confluence
- Maintain county agency contact lists
- Coordinate system access requests for county staff
- Conduct outbound calls to members to assist with outreach and surveys
- Enter data into CareConnect, including opening/closing cases, notes, and assessments
- Assist with Pre-Admission Screening (PAS) referrals to ensure timely notification to pertinent county staff
General PrimeWest Health Responsibilities
- Abide by the PrimeWest Health Code of Conduct Comply with all PrimeWest Health policies and procedures Comply with the Health Insurance Portability and Accountability Act (HIPAA) and all other privacy laws Be familiar with building safety procedures and alert maintenance if something requires attention Keep public areas of the department and office neat and clean Conduct other responsibilities and activities as needed and assigned
Professional Competencies
- Strong interpersonal skills
Educational Requirements and Required Qualifications
- At minimum, an associate degree or diploma in administrative assistance or two years of experience equivalent to the position requirements. Demonstrated knowledge of, and proficiency in, Word, Excel, and Outlook required. Experience with data entry and taking meeting minutes is a plus. Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Good verbal and written communication skills. Ability to sit at a desk or computer station most of the time. Ability to occasionally lift and/or carry such articles as file folders and small boxes up to 30 pounds.
Appropriate Licensure and Certification Requirements – N/A
Collaborative Efforts with Other Departments
- Administration Business IT & Claims Administration Corporate Compliance & Auditing Information Systems & Technology Member & Provider Services Operations Pharmacy Management Quality & Utilization Management
Supervision – N/A
This position description is not to be construed as an exhaustive statement of essential functions or responsibilities.
Location: Alexandria, Minnesota – This is a hybrid or in-office position
PrimeWest Health is an Equal Opportunity Employer Committed to Diversity, Equity, and Inclusion