Kaiser Permanente Verified
Healthcare, Managed Care, Hospitals & Health Systems
Pop Mgmt Support Coordinator
Reno, NVOnsiteFull TimePosted 1 month agoVisa sponsorship available
Required skills
- patient communication
- patient care setting
- patient records
- program databases
- performance metrics
- healthcare professionals
- quality care outcomes
- care team
- data reporting
- computer applications
Nice to have
- integrated care delivery system
- Associates degree
- Healthcare field
- LPN
- MA license
- Epic
Role summary
Coordinates outreach activities to support quality improvement initiatives by identifying, tracking, and engaging patients. Maintains program records, databases, and performance metrics to support organizational goals and regulatory requirements. Collaborates with healthcare professionals to connect patients with appropriate resources and services that promote quality care outcomes.
Job Summary: Coordinates outreach activities to support quality improvement initiatives by identifying, tracking, and engaging patients. Maintains program records, databases, and performance metrics to support organizational goals and regulatory requirements. Collaborates with healthcare professionals to connect patients with appropriate resources and services that promote quality care outcomes.
Essential Responsibilities:
Basic Qualifications:Experience
Essential Responsibilities:
- Focuses on the needs of members/patients to develop and sustain productive member/patient relationships. Actively seeks information to understand member/patient circumstances, problems, expectations, and needs.
- Using established measures and criteria to identify patients within specific care programs, explains the need and answers questions related to specific programs, testing and outreach. Reviews patient medical record; and/or computer data to determine the need for further follow up and relays information to patient.
- Coordinates with care team at assigned clinic, collects data and maintains program databases and reporting. Tracking patient populations to obtain statistical information related to specific program goals associated with health care management and assure that patient records are updated.
- Reviews and identifies pertinent medical information in patient records; and other source documents; collects and applies codes as needed. Enters the appropriate codes for patient diagnosis, treatment, test result, or activities in the program tracking files, and chart.
- Verifies database information entered for errors and reports any issues or concerns through appropriate escalation pathway.
- Using established formats, develops letters, forms and other media required to educate and retrieve information from patients associated with specific care programs.
- Contact patients by phone and correspondence as pertaining to plan of care.
- Performs audits and compiles data for reports, program evaluation and QA activities and compliance.
- Supports care team by generating annual screening, utilization, compliance and other reports associated with care management programs and program performance.
- Processes internal and external medical referrals, reviews referral for completeness and requests additional information as necessary, functions as a liaison, and works independently; verifies member eligibility, ensures appropriate nurse assistance, enters information in the system; and outreaches members for scheduling and approvals as needed; responds quickly to meet member/patient needs and resolves problems. Manages external referrals and data for processing.
- Informs patients and providers of referral process and limitations, associated charges, appointments, and member responsibilities. Answers questions concerning eligibility, benefit coverage, referral policies and procedures, coordination of benefits and contracts.
- Supports members/patients in navigating health plan benefits and services, including helping members understand available benefits, eligibility requirements, and appropriate access points for care and support services.
- Assists members/patients with scheduling appointments, coordinating follow-up care, and connecting with appropriate clinical, administrative, or health plan resources to support timely access to care.
- Provides member-facing support for health plan benefit navigation, including transportation benefits, travel reimbursement processes, benefit coverage questions, and other plan-supported services.
- Serves as a liaison between members/patients, care teams, health plan departments, and external vendors to help resolve access barriers and ensure members receive appropriate services.
- Educates members/patients on available health plan resources and assists with forms, documentation, referrals, reimbursement requests, or other administrative steps needed to access covered benefits.
- Tracks member needs, outreach activities, benefit-related requests, and follow-up actions in appropriate systems to support care coordination, reporting, and timely resolution.
Basic Qualifications:Experience
- Minimum two (2) years of experience in a medical office, healthcare, or patient care setting, including direct patient communication, assessment of clinical needs, and experience working independently with limited supervision.
- Minimum two (2) years of experience performing administrative and technical duties, including data reporting, analysis, and proficiency with computer applications.
- High School Diploma or General Education Development (GED) required.
- N/A
- Ability to utilize computer systems and applications to schedule appointments, maintain records, and track member information.
- Ability to assess member needs, review relevant health information, provide program information, and coordinate appropriate screening, diagnostic, and follow-up services.
- Knowledge of procedures for maintaining and researching confidential information and the importance of medical data.
- Ability to plan, organize, and coordinate daily work activities while maintaining accuracy, efficiency, and attention to detail.
- Ability to communicate effectively and professionally with members, providers, and staff while delivering responsive, member-focused service.
- Demonstrated verbal and written communication skills.
- Three (3) years of experience working in an integrated care delivery system.
- Associates degree in a Healthcare field.
- LPN or MA license or certification.
- Proficient computer skills with Epic and Microsoft Office Suite (Outlook, Teams, Excel and Word)
