Insurance & Value Care Specialist | Community Health Center

Insurance & Value Based Care Specialist| Community Health Center

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Odyssey House Louisiana, Inc. is seeking a full-time Insurance & Value Based Care Specialist for its Federally Qualified Health Center. The schedule is Monday-Friday 8am-5pm.

Inthis role, the Insurance & Value Based Care Specialist will verify insurance coverage for all clients and enter information in a timely manner into our EHR. In addition, the Insurance & Value Based Care Specialist will be responsible for ensuring the utilization of billing codes to optimize health centers' Value-Based Care programs.

It is the duty and responsibility of the Insurance & Value Based Care Specialist to:

• Work with the Director to understand,precisely document, and prioritize all value-based contract requirements, andthen organize these requirements into a coherent roadmap that outlines key activities and milestones.
• Use available data and best practices todevelop creative and innovative strategies, interventions, and other performance improvement strategies in collaboration with health center members.
• Track payer payments and elevate issuesas necessary to the Director.
• Prepare and present progress against goals monthly to Director
• Responsible for providing project coordination, analytical reporting, and operational support for increasing access to health services with/for an identified population through the health centers’ care management team
• Increase accessto health services with/for an identified population through the health centers’ Clinic Leadership team as directed by Director
• Develop, maintain, share, and educate stakeholders on complex analytical models supporting data literacy
• Lead practice transformation and practice performance improvement initiatives
• Guide Health Centers in achieving targeted goals and outcomes, to improve quality,efficiency, and utilization
• Use data to identify and deliver actionable insights to key stakeholders, including trendsin prescribing and new opportunities for improvement
• Work with Clinic Leadership team to improve chronic disease management and promote preventive care, as appropriate, to reduce the utilization of inappropriate care settings(e.g., avoidable emergency department visits)
• Develop transformation plan, including strategies for improvement in utilization metrics and HEDIS and other Quality Measures, based on performance analysis data and established targets
• Facilitate effective practice improvement meetings with Director, to monitor, present, and discuss progress on the transformation plan
• Analyze cost,utilization, and quality data from multiple data sources, including, but not limited to, payer portals and payer claims
• Establish relationships, gather input, and facilitate communication amongst key stakeholders
• Use data dashboards to educate and foster opportunities for change in clinical workflow
• Review monthly practice team reports and facilitate improvement strategies
• Verify insuranceinformation for all appointments
• Update insuranceinformation in EHR for all appointments
• Update utilization of billing codes in EHR to ensure health center optimizes Value Based Care programs
• Other duties,as assigned.

• Bachelor’s degree either in health care administration, nursing, business management, public health, or another health-related field preferred. A person not possessing a bachelor'sdegree may be considered if their combination of education and experience matches what is needed for this role.

• Knowledge of CPT codes and basic medical terminology (preferred)
• Value-Based Care experience
• Phone communication skills
• Bilingualability (English/Spanish)

Competitive Compensation and Benefits package includes insurance (health, dental, vision, life, long-term and short-term disability), leave benefits and 401k match.