Quality Specialist - Summit Health : Job Details

About Our Company

We're 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 all. We 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.

Job Description

Job Description

In this role, 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 Can Make A Difference

You can expect the following professional challenges:

* Call patients to ensure they refill their chronic disease medications on time for diabetes, blood pressure, and cholesterol

* Contribute to increasing overall quality ratings for the clinic by ensuring patients refill and take their medication on time and as directed

* 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 the provider's plan to the 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 the 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 pharmacists, 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

* Coordinate with pharmacy staff, primary care office staff and/or providers to ensure appropriate referrals, orders, and tests are in place for the patient

* Schedule appointments and testing and/or order screenings per standardized protocols

* Maintain current knowledge of quality measure requirements

* Identify opportunities for continuous process improvement

* Actively participate as a member of the healthcare team to promote positive health outcomes for our patients and support our healthcare partners

* Scheduling patient appointments as needed for refills/barriers

* Assisting other quality departments as required per quarter

* Participating in team-building exercises/tools

Skills For Success

* A high level of personal accountability and ability to work independently/remote

* Superior relationship and interpersonal skills with the ability to craft meaningful relationships

* A service orientation and a can do attitude

* Bias for action with a solution-oriented approach

* A low ego and humility; an ability to gain trust through good communication and doing what you say you will do

* An ability to focus on outcomes and team performance utilizing a high level of collaboration and a sense of team-based work product and results

* Ability to listen actively and empathically to patients who may be struggling with medication adherence

* A high level of integrity and respect for patients while assisting them with their medications

* Ability to apply behavior modification techniques and motivational interviewing skills to properly identify and help resolve medication nonadherence barriers.

* Ability to de-escalate and properly respond to patient concerns

* Strong written and verbal communication skills

* Strong attention to detail and follow-through

* Ability to work efficiently with multiple providers, clinic locations, and insurance plans

* Ability to navigate within ambiguity and be solution-oriented

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 noise?required

* 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

How you will thrive

In addition to?competitive salaries, a 401k program with company match,?bonuses, and a valuable health benefits package,?VillageMD?offers?paid parental leave,?pre-tax savings on commuter?expenses, and generous paid time off.?You work in a highly collaborative, conscientious, forward-thinking environment?that welcomes your experience and enables you to make a significant impact from Day 1.

You also have the flexibility to contribute remotely. Most importantly, you make a difference. You see a clear connection?between?your daily work on?VillageMD?products and services and the advancement of innovative solutions and improved healthcare quality for providers and patients.

For Colorado Residents only: This is a non-exempt position. The base compensation range for this role is $21-22.50/hr. At VillageMD, compensation is based on several factors including but not limited to education, work experience, certifications, location, etc. The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.

About Our Commitment

Total Rewards at VillageMD

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 VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Company provides 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.

Safety Disclaimer

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