Quality Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct outbound calls to patients regarding clinical programs, medication adherence, and addressing care gaps for patients under value-based contracts.

• Reach out to patients to confirm timely refills of medications for chronic diseases such as diabetes, hypertension, and cholesterol management.

• Act as a liaison among patients, clinics, and pharmacies to reduce gaps in medication refills.

• Analyze patient medical histories and relay providers’ treatment plans to patients effectively.

• Navigate various Electronic Medical Record (EMR) systems efficiently.

• Accurately document patient care activities in electronic health records.

• Conduct medication reconciliation processes.

• Request medication refills in accordance with clinic policies and protocols.

• Assist patients in overcoming medication access challenges, including cost-related issues.

• Identify patients who require referrals to pharmacists, pharmacy medication programs, care management, clinicians, or Village at Home services.

• Follow up with patients, providers, and pharmacies to ensure medications are collected and administered as prescribed.

• Coordinate quality health maintenance activities before and after primary care appointments.

• Schedule appointments and testing and order screenings based on standardized protocols.

• Stay updated on quality measure requirements.

• Arrange patient appointments for medication refills and address barriers.

• Provide assistance to other quality departments as necessary.

• Collaborate with pharmacy personnel, primary care office staff, and providers regarding referrals, orders, and tests.

• Contribute to enhancing clinic quality ratings through improved medication adherence.

• Recognize opportunities for ongoing process enhancements.

⛳️ Requirements

• High school diploma or GED equivalent is mandatory.

• Certification as a Medical Assistant, Certified Pharmacy Technician, or relevant healthcare experience is required.

• Intermediate to advanced keyboarding abilities, including a minimum typing speed of 35 WPM, touch typing, and document formatting skills.

• A secure home workspace equipped with a desk and chair, ensuring minimal background noise.

• Home internet access provided by the candidate.

• Minimum internet download speed of 100 Mbps and upload speed of 10 Mbps is required.

• A hard-wired internet connection using an Ethernet cable; Wi-Fi is not permitted.

• At least 1 year of experience in a healthcare environment is preferred.

• Previous experience with Electronic Health Records is preferred.

• Experience in call center or telephonic roles is preferred.

• Familiarity with Medicare Advantage plans, insurance, and medication adherence is preferred.

• Bilingual proficiency in English and Spanish is preferred.

• Certification as a Medical Assistant or Certified Pharmacy Technician, or equivalent experience in a healthcare setting is required.

🏝️ Benefits

• Medical coverage

• Dental coverage

• Life coverage

• Disability coverage

• Vision coverage

• FSA coverage

• 401k savings plan

• Work from home arrangement