Patient Outreach Specialist

Organization:

SDMC-Sutter Delta Medical Center

Position Overview:

Responsible for the implementation of the various outreach programs, translating operational procedures into step-by-step activities to coordinate activities needed to achieve program goals. For each program, this includes identification and resolution of complex issues; coordination of procedures and products with labs and vendors; building communication campaigns; development, maintenance and day-to-day administrative activities; and providing feedback and recommendations for process improvement. This position will work with a wide audience, including members, physicians and their staff, lab staff and vendors, in order to process and research complex issues and to administer the program for successful results.

Job Description :

WORKFLOW OF THE PROGRAM:

• Develop step-by-step process for each Program.

Analyze and determine steps that need to be taken in order to successfully achieve program roles.

• Supports the identification and ranking of Pay for Performance (P4P) disease specific member populations; support and coordinate the development and distribution of standardized and other ad hoc reports.

• Conducts initial review and analysis of population lists/reports.

• Works with reporting analysts to develop and maintain processes and timelines for population identification, stratification and reporting based on defined criteria.

• Collaborates with management and P4P project team and/or appropriate external staff for report interpretation.

• Assist with creating annual P4P Outreach work plans and maintains schedule tasks.

• Monitor accuracy and completeness of data collected and recommends improvements to data collection tools and processes.

• Supports and is accountable for the accuracy of patient identification, status related to P4P identification rules used within the P4P Outreach process, including adequate review and testing.

• Develops/obtains all records, forms and printed materials needed to initiate P4P outreach process.

• Build and maintain relationships with physicians, staff, labs and vendors to ensure smooth coordination of efforts. Identify and resolve any issues that could impinge the smooth workflow of processes, including coding, products, referral requests, etc

• Maintain spreadsheets and/or databases to track the sequential contact activity of each identified member and to “work” the list to perform the next level of communication in the predetermined timeframes.

• Coordinate and perform the outbound communication processes through the use of a series of escalating communication venues.

• Maintains patient letters, PCP faxes, client correspondence and

• related documents and files; develops and maintains storage filing system, including back-up procedures for all documents and correspondence.

• Coordinate vendor activities to ensure smooth patient communications. Work with outside vendors to set up outbound Televox calls and automated MSI letters for identified members. Audit communications to ensure accuracy.

• Contribute to the development, implementation and monitoring of policy and procedure relating to the operations of the P4P Outreach processes.

RELATIONSHIPS:

• Serves as general operations resource to the P4P Outreach team.

• Act as P4P Outreach liaison to clients, imaging centers, labs and providers for issues related to P4P Outreach, ensuring a complete understanding of expectations and requirements.

• Research and/or verify member issues; seek resolution using a variety of resources.

• Act as a liaison between the member and their physician’s office or the labs to assist in the coordination of scheduling appointment(s) and/or resolution of issues.

• Influence member participation in the program, using persuasive and motivational techniques to encourage members to complete recommended steps to comply with Outreach objectives (e.g. schedule appointments for tests and procedures, such as mammogram, complete lab work, etc).

• Coordinates patient callbacks as needed to assure optimal outreach resolution (compliance) is reached with identified patient population.

Tracks and reports completion of screening/intervention with laboratories, imaging centers or other means (e.g. coordinating with reporting analyst using claims data) to ensure patient follow through on intervention and outreach efforts.

• Supports the coordination of physician office staff education on P4P Outreach issues.

• Prioritizes and reports concerns, improvements, and possible quality issues.

• Maintains administrative statistical reports, department files, reference materials, and policy manuals to ensure proper availability and retrieval.

• Receive and respond to inquiries (phone, email, written, fax) from assigned providers and/or Foundation administration regarding a variety of P4P Outreach related issues.

• Coordinates and problem-solve all information system issues with the appropriate department.

REPORTS:

• Compiles, maintains and reports information on operations, including productivity, quality improvement and related data in a complete and accurate, and accessible manner.

• Communicates with members, physicians and foundations/clients as directed by program policies.

• Track and analyze utilization statistical data and presents to administration regularly or as needed.

• Attend any/all department and company meetings as indicated by the Disease Management Manager.

• Adheres to organizational policies and procedures and supports Sutter Health’s philosophies and initiatives..

• Attends staff meetings and training sessions, as needed or required.

• Assists in assessment, development, implementation, and evaluation of special projects.

• Meets deadlines on special projects as assigned.

• Creates and promotes positive working relationships internally and as well as with external clients.

• Collaborates with appropriate personnel to achieve special project goals.

• Demonstrates a positive working attitude and diplomatically offers constructive work suggestions.

• Maintains professional manner and work ethic

• Develop and maintain relationships through interactive, client-facing meetings

• Prepare Client Communications, as needed, to communicate important information, changes and/or reminders to providers and staff on P4P Outreach information and updates.

EDUCATION:

Equivalent experience will be accepted in lieu of the required degree or diploma.

Bachelors

SKILLS AND KNOWLEDGE:

Ability to be highly persuasive and to effectively convince members with possible aversion to the program to commit to a prescribed action (i.e., scheduling and having a mammogram, etc.)

Demonstrated ability to openly and comfortably discuss sensitive topics with members of both genders

Able to build positive relationships with a variety of clients

Detail oriented and able to handle multiple projects simultaneously

Ability to handle a large volume of inbound and outbound telephone calls for a variety of clients

Written and verbal communications skills

Proficient in Microsoft software products, including Word and Excel

Able to work in a fast-paced environment

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday – Friday

Weekend Requirements:

Occasionally

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

40

Employee Status:

Regular

Number of Openings:

1

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $32.79 to $42.62 / hour

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a drivers license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.