Attribution Specialist - HMS

Position Summary

Rural Health Group at our Halifax Medical Specialists location is seeking a compassionate, organized, and motivated Attribution Specialist to play a key role in connecting patients back to care and supporting our value-based care efforts. The Attribution Specialist is responsible for engaging attributed patients—particularly those not yet established or recently disengaged from care—by phone and other outreach methods. This role helps ensure patients receive needed preventive and chronic care services by identifying care gaps, providing education, and coordinating follow-up.

• Conduct outbound calls to patients attributed to RHG under value-based contracts but not currently engaged in care.
• Use motivational interviewing techniques to build trust, encourage appointment scheduling, and overcome barriers to care.
• Provide culturally sensitive and respectful communication tailored to each patient's needs.

• Review patient charts and reports to identify open care gaps (e.g., overdue mammograms, colonoscopies, A1C checks, hypertension follow-up).
• Educate patients on the importance of preventive care and chronic disease management, empowering them to take action.
  • Example: Explain to a patient why regular A1C testing is important in managing diabetes and preventing complications.
  • Example: Inform a patient about the benefits of colorectal cancer screening and help schedule the appropriate test.

• Review and manage patient attribution lists from Medicaid, Medicare, and commercial value-based plans.
• Accurately document all outreach and patient interactions in the electronic health record (EHR) or care management systems.
• Track progress on care gap closures and follow-up needs.

• Attend internal and external value-based care meetings, payer performance calls, and team huddles.
• Collaborate with care coordinators, providers, front desk staff, and quality improvement teams to close care gaps and streamline patient access.
• Share feedback and insights from patient interactions to improve outreach strategies and care coordination workflows.

• High School Diploma or equivalent required.
• Previous experience in healthcare outreach, case management, care coordination, or patient engagement is strongly preferred.
• Familiarity with FQHC operations and populations is a plus.
• Proficiency in electronic health records (EHR) and Microsoft Office Suite.
• Bilingual (English/Spanish or other prevalent languages in the service area) strongly preferred.

• Excellent verbal communication and active listening skills.
• Demonstrated ability to connect with patients from diverse cultural and socioeconomic backgrounds.
• Motivational interviewing or patient coaching experience.
• Knowledge of common preventive health measures and chronic disease management.
• Detail-oriented with strong organizational and documentation skills.
• Able to work independently while also collaborating in a team environment.
• Committed to RHG’s mission, vision, and service to underserved communities.

• In-person, office-based
• May involve occasional travel to RHG sites or community-based events.

At RHG, you’ll be part of a mission-driven team focused on expanding access to high-quality healthcare across Northeastern North Carolina. You’ll play a vital role in connecting patients to the care they need and helping improve outcomes in some of our most underserved communities. Your work will directly support our commitment to being the first choice for quality healthcare—where all are valued, respected, and appreciated.