Patient Retention and Utilization Specialist

Overview

“To enhance the quality of life for men, women and children in the greater Los Angeles area through the provision of high quality, accessible and affordable healthcare services.”

We offer fantastic benefits, competitive pay, and a great family-oriented environment!

We offer:

• Medical Benefits - FHCCGLA pays 100% of employee’s Kaiser;
  Anthem Blue Cross;
  Health Net; and United Health Care coverage (HMO Plan) subject to change during open enrollment.

• 403 B
  - Through Mutual of America, the company matches up to 5% of employee’s salary.

• Dental Benefit
  - Met Life Only (HMO/PPO Plan).

• 11 Holidays Observed.
• 2 Floating Holidays

• Vision Benefit
  -Met Life Plan.

• 1 Birthday Holiday

• Life Insurance
  - Accidental Death & Dismemberment; and Long-term Disability.

• 7 Paid Sick Leave - 56 hours Full-Time
• Paid Sick Leave – 40, Part-Time and Per-Diem

• Employee Assistance Program

• 2 weeks’ Vacation

• AFLAC Benefits

This would be a great opportunity to make a difference with you onboard!

POSITION TITLE:Patient Retention & Utilization Specialist

DEPARTMENT: Quality Improvement

REPORTS TO: Quality Improvement (Q.I.) / Risk Management Coordinator

POSITION OVERVIEW:

The Patient Retention & Utilization Specialist is responsible to contact all applicable patients to attempt retention efforts and/or ensure increased utilization of all needed FHCCGLA services. The primary focus of this position will be maintaining patient retention and maximizing utilization of services. Shall outreach to active and non-active patients who have not received services within the recommended periodicity.

DUTIES/RESPONSIBILITIES:

• Responsible for establishing and implementing strategies to improve utilization and retain patients through changes.
• Collaborates with other departments to increase retention, utilization and access to care and services as needed.
• Enhance communication with patients regarding FHCCGLA services to improve quality service, reduce no-show rates, retain patients and ensure utilization of all services such as:
• Women’s Health
• Behavioral Health
• Dental
• Optometry
• Nutrition
• Podiatry
• Works in conjunction with quality improvement department with guidance from the C.M.O. to develop and implement strategies to better engage and retain patients.
• Contacts new and non-active patients to connect them to pertinent care services.
• Responds to patients’ inquiries and follows-up on patient issues and resolutions to ensure quality customer service.
• Coordinates resources to improve patient ability to adhere to appointments, including assistance with transportation.
• Maintains knowledge of eligibility, enrollment, and program specifications for CHDP, Medi-Cal, Medicare and other insurance programs.
• Conducts GAP reports from, Next Gen and COZEVA to track utilization of services and determine which patients are due for various preventive care health maintenance measures and follow-up.
• Follows all FHCCGLA safety, regulations, practices and policies & procedures.
• Works with the operations managers to manage patient scheduling and flow to address bottlenecks, scheduling issues, etc. – notifies supervisor of all concerns.
• Ensures HIPAA compliance by maintaining strict confidentiality of all patient data and E.H.R./Practice Management System (PMS) according to regulations and FHCCGLA’s P&P’s.
• Remains informed of specific programs/payors, insurances accepted, and services being offered at FHCCGLA.
• Serves as a liaison between clients and medical staff.
• Assists clients with completion of forms.
• Educates clients regarding available benefits (health coverage programs) and will refer directly to FHCCGLA outreach & enrollment specialists for eligibility screening and/or application assistance.
• Participates in key pertinent meetings, such as:
• Quarterly Staff (Q.S.) Training
• Q.I./Q.A.…