Summary:
The Quality Care Gap Specialist has duties and responsibilities related to closure of preventive care gaps and follow-up patient care needs. The functions of this position include care coordination, care gap closure, chart reviews, auditing and monitoring of quality initiatives and patient navigation/education. The Quality Care Gap Specialist conducts outreach to patients who are identified as needing preventive and/or follow-up care services in support of quality initiatives and regulatory/contractual requirements. The Quality Care Gap Specialist provides education to members regarding the need for preventative care. The individual maintains confidentiality of business and protected health information and must be an advocate for the Patient Centered Medical Home.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Key Functions:
OTHER ESSENTIAL DUTIES and RESPONSIBILITIES:
GENERAL DUTIES:
QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
SKILLS:
EDUCATION and/or EXPERIENCE:
High School diploma or GED in general field of study.
Minimum of 2 years clinical experience or managed care/health plan experience.
Fluency in evidence-based care guidelines for disease prevention.
Experience with electronic medical records.
Experience related to quality management/performance improvement preferred.
BENEFITS:
Grace Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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