Aetna Outreach Coordinator, HEDIS in Harrisburg, Pennsylvania
Req ID: 55082BR
Makes outbound calls to members to provide assistance in obtaining services (i.e., provide reminders, make appointments, arrange transportation, etc.) to avoid delays in treatment and improve member health outcomes. Identifies when to refer member to Social Worker or Case Manager.
Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes.
Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.
Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.
Minimum 3 years' recent and related health care outreach and/or health education experience
Recent and related experience with HEDIS criteria
Experience in call center environment
Strong communication skills and experience speaking with medical providers
Ability to work independently
Ability to use standard corporate software packages and corporate systems
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Functional - Communications/Member communications/1-3 Years
Functional - Customer Service/Call center monitoring & analysis - Inbound calls - call center location/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
ADDITIONAL JOB INFORMATION
This is an exciting opportunity to work with an expanding team within Medicare Healthy Outcomes.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Quality Management
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.