Care Gap Coordinator

US-CA-Orange
Job ID
2017-5423
Category
Clinical Services

Overview

The Care Gap Coordinator functions as a gate keeper for Call Center tasks and coordinates patient flow for providers. Submits and monitors HEDIS referrals through AltaMed Net. Also provides technical/clerical support in the clinical setting as necessary.

 

Responsibilities

  1. Function as a care gap coordinator in facilitating and completing tasks or delegating to appropriate staff/provider prioritized all incoming task from refill medications, reschedule appointments (referral or no-show follow up), and answer in-scope patient care questions.
  2. Act as BO/FO communication intermediate and coordinator of patient flow.
  3. Collaborate with providers and back office staff in accommodating late patient arrivals based on schedule workload and availability. Responsible for submission and proactive follow-up for the Provider (tracking and updates) on all patient care related referrals.
  4. Use AltaMed Net to review status of referrals, as well as, modify, extend and renew referrals as necessary.
  5. Communication with patient on referral status, specialty appointments, and obtaining appropriate specialty documentation as necessary.
  6. Participate in team huddles and highlight next day patient information to review with Provider Partner (HEDIS and standing orders, request records, ensure appointment is appropriate/necessary).
  7. In collaboration with the provider team, responsible for advance scrubbing of provider panel and rescheduling appointments that do not meet scheduling guidelines.
  8. May check inventory, order immunizations, quality control for supplies as assigned.
  9. Float for other CGCs or Provider Partner when asked.
  10. Performing within the individual’s scope of practice, make outbound calls to pts as directed by provider, answer incoming calls, and documenting all patient care interactions in the telephone template of the EHR.
  11. Perform HEDIS outreach calls for the assigned provider team as assigned.
  12. Submit and follow up on all medication prior authorizations as needed.

Qualifications

  1. High School diploma or equivalent required.
  2. Medical Assistant certificate, and CPR/First Aid certificate required.
  3. NextGen advanced training required.
  4. 3 years’ experience as a back office Medical Assistant required.
  5. Bi-lingual English/Spanish/Mandarin/Cantonese strongly preferred.

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