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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Outreach Coordinator HEDIS

Primary Location: Las Vegas, Nevada
Additional Locations: NV-Las Vegas
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Description:
Works with internal staff across multiple departments to identify data sources, processes and activities required to meet regulatory and accreditation requirements or meet the objectives of the QM program. Conducts outreach with complex provider partners.

Fundamental Components:
  • Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measures.
  • Makes outbound calls to members to provide assistance in obtaining services (i.e., provide reminders, make appointments, arrange transportation, etc.) to avoid delays in treatment and improve member health outcomes.
  • Identifies when to refer member to Social Worker or Case Manager.
  • Develops and distributes educational information to members and providers in accordance with the HEDIS outreach work plan (mailings, social media, automated calls, etc.)
  • Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.
  • Documents member participation in outreach activities in accordance with abstraction and audit standards.
  • Conducts HEDIS provider chart request calls and mailings.
  • May develop and maintain member incentive programs to support HEDIS initiatives.
  • Maintains incentive database to track member compliance.
  • May identify opportunities to partner with community organizations on special events and presentations (i.e., health fairs and community events).
  • Works with internal staff to schedule, organize, and staff these events.
  • Records and documents all member and provider outreach activity.
  • Performs other duties as required.


Background Experience:
  • Ability to use standard corporate software packages and corporate applications.
  • Strong communication skills and experience speaking with medical providers.
  • Recent and related experience working with HEDIS criteria
  • Ability to work independently.
  • Experience working in call center environment
  • Minimum 3 years' recent and related health care marketing, outreach and/or health education experience.
  • Bachelor's degree or equivalent experience.


Additional Job Information:
This
is an exceptional opportunity to do meaningful work to build a healthier world
by improving the quality of health care for those that we serve at one of
America's leading health benefits companies. Aetna is about more than just
doing a job. This is our opportunity to re-shape healthcare for America and
across the globe. We are developing solutions to improve the quality and
affordability of healthcare. What we do will benefit generations to come. We
care about each other, our customers and our communities. We are inspired to
make a difference, and we are committed to integrity and excellence. Together
we will empower people to live healthier lives. Aetna offers a competitive
salary and a generous benefits package. Aetna is an equal opportunity &
affirmative action employer. All qualified applicants will receive consideration
for employment regardless of personal characteristics or status. We take
affirmative action to recruit, select and develop women, people of color,
veterans and individuals with disabilities. We are a company built on
excellence. We have a culture that values growth, achievement and diversity and
a workplace where your voice can be heard.


Required Skills:
Benefits Management - Maximizing Healthcare Quality, General Business - Applying Reasoned Judgment, Leadership - Collaborating for Results

Desired Skills:
General Business - Maximizing Work Practices, Service - Improving Constituent-Focused Processes, Technology - Leveraging Technology

Functional Skills:
Clinical / Medical - Quality management

Potential Telework Position:
Yes

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Click To Review Our Benefits (PDF)

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