Patient Care Advocate

Patient Care Advocate

Responsibilities:

• Acts as a liaison and member advocate between the member/family physician and facilities/agencies.

• Acts as the face of WellCare in the provider community with the provider and office staff where their services are embedded.

• Advises and educates Provider practices in appropriate HEDIS measures and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements.

• Assesses provider performance data to identify and strategizes opportunities for provider improvement.

• Collaborates with Provider Relations to improve provider performance in areas of Quality Risk Adjustment Operations claims and encounters.

• Schedules doctor appointments for members with care gaps to access needed preventive care services and close gaps in care in the providers office.

• Conducts face-to-face education with the member and their family in the providers office about care gaps identified and barriers to care.

Requirements:

• Bachelor's degree (Healthcare, Public Health, Nursing, Psychology, Social Work, Health Admin, etc.) -AND- 2+ years of experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment.

• OR-

• No bachelor's degree - AND- 4+ years of experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment.

• One of the following Licenses/Certs preferred:

• Licensed Practical Nurse (LPN)

• Licensed Master Social Work (LMSW)

• Licensed Clinical Social Worker (LCSW)

• Licensed Social Worker (LSW)

• Certified Social Worker (C-SW)

• Clinical Social Work Associate (CSWA)

• Licensed Registered Nurse (RN)

• Experience with member outreach.

• Basic understanding of measure specs.

• EMR/EHR experience.

• Proficiency with MS Office.

• Computer proficiency.

• MUST be located in Oregon.

Pay: $25

Shift: Mon-Fri, 8am-5pm

Environment: 100% Remote/Work From Home - required to reside in Oregon & work PST hours.

Duration: 13 weeks

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About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent

• Maintaining an inclusive environment through persistent self-reflection

• Building a culture of care, engagement, and recognition with clear outcomes

• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.