Health Concierge

Job Description

Job Description

Position Summary

The Health Concierge position is a non-clinician role that works in collaboration with the Care Management staff and / or quality improvement staff to support the multi-disciplinary team approach of patient care by meeting key performance indicators (closing care gaps, reducing hospitalizations, readmissions, ED (Emergency Department) utilization, and PMPM costs) and other organizational mandates as designated. The Health Concierge may work remotely within regions to cover the needs across the state and / or may work on site at CCPN (Community Care Physician Network) practices.

Health Concierges may directly assist members by increasing their ability to improve their health outcomes. They also help design and implement systems to ensure the smooth operation of office functions and to support the Care Team.

Health Concierges may also work directly with assigned practices to assist them in addressing care gap closure in collaboration with the Provider Relations Representative / QI Team.

Essential Functions

• Receive and document all referrals from various sources into the Care Management documentation platform.
• Outreach, engagement, and scheduling of members for Care Managers.
• Verify eligibility and demographic information.
• Complete appropriate screenings as needed.
• Assist with mailing educational materials, consent forms or other documents to the member as necessary.
• Assist with referrals on behalf of the Care Management or program team.
• Assist with tasks delegated by the Care Management or program team.
• Provide information for access and coordination of resources.
• Assist member with care coordination and health care system navigation.
• Provide culturally appropriate health education and information.
• Provide general education and social support.
• Advocate for members.
• Identify care gaps and outreach to members to close gaps as requested.
• Assist practice to submit supplemental data to health plans to provide documentation of gap closure as requested; assist with scheduling medical appointments and transportation as needed.
• Assist with pulling Care Gap / Recommended Actions / High Risk reports.
• Assist in addressing Social Determinants of Health as needed.
• Access multiple EHRs (electronic health records) to obtain and upload documents into the care management platform.
• Access to Hospital / Data or Electronic Medical Record system will be required, as necessary.
• Meet productivity and role expectations as defined.
• Collaborate with the Care Team to address barriers and create efficiency with processes.
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded.
• Abide by department guidelines, company policies, and HIPAA regulations.
• Perform all other duties as requested.
• Attend Departmental and corporate meetings, local and regional trainings, or other events as required.
• Understand and uphold CCNC goals, objectives, and standards.
• Travel using personal vehicle will be required within the region and / or the State.

Qualifications

Working Conditions