Job Description

The Health Promotion Specialist is responsible for tasks related to increasing compliance with performance measures and promoting comprehensive health care for members.


Medical Record Review:
* Contact providers / members to locate patient medical records
* Encourage and follow up with providers to ensure timely response to requests for medical records
* Process medical records timely
* Update MRR database accurately and timely
Focus on maintaining or improving quality outcomes:
* Manage incentive program to encourage members to have recommended screenings and tests.
* Contact members via telephone and/or mail
* Communicate with providers on member related issues
* Identify new opportunities to encourage members’ personal responsibility for their health care


Identify, refer and/or coordinate care for members with specific medical and social needs
* Outreach to members referred to services to verify that needs have been met
* Maintain database and documentation
* Coordinate with PCP, local department of health, Medicaid

 

Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled


 



Qualifications

Knowledge:
Knowledge of Medicaid and Medicare regulations and guidelines
Knowledge of childhood immunization requirements, HEDIS, CAHPS, HOS and 5-Stars
Familiarity with medical terminology
Knowledge of the AHCCCS EPSDT or Utah CHEC program helpful

Skills:
Computer experience necessary
Effective time management skills
Effective interpersonal and communication skills

Abilities:
Ability to use electronic medical record and claims systems
Problem solving abilities
Work cooperatively, positively, and collaboratively in an interdisciplinary team
Work respectfully and positively with members
Ability to prioritize work tasks to adhere to deadlines and identified time frames

Education:
High school degree or equivalent GED preferred


Experience:
Experience in a managed care organization or related healthcare delivery system preferred

Application Instructions

To apply directly to Steward Health Care, please click the link below. Another window will open and allow you to apply directly online.

Apply Online