To partner with MAPMG and Health Plan Operations in the achievement of service and clinical quality delivery objectives and goals specific to population care. To ensure the development and implementation of evidence-based population care management programs for targeted populations of members in accordance with established standards and guidelines.
Essential Functions:
- Coordinates and documents safety net programs.
- Collaborates with clinical and operational staff to implement safety net and Medicaid programming.
- Coordinates preventive care and disease management outreach initiatives to members with Medicaid.
- Supports the development and maintenance of safety net and Medicaid programs in accordance with NCQA and state/city (MD/VA/DC) standards.
- Supports Population Care Management accountabilities to Quality and Resource Management.
- Consistently communicates and documents all quality improvement and patient care activities in compliance with organization and department guidelines.
- Practices and promotes innovative practice within ethical and legal guidelines using established policies and procedures.
- Maintains confidentiality of patient records, information, and departmental activities involving patient information.
Qualifications:
Basic Qualifications:
- Two (2) years of clinical experience.
- Bachelor's degree required.
- Licensed Practical Nurse (LPN) required.
- Demonstrated ability to develop and maintain collaborative activities and communications to help achieve program objectives required.
- Demonstrated excellent written, verbal, and electronic communication skills required.
- Demonstrated problem solving and decision-making skills required.
- Demonstrated drive for results in the areas of member and practitioner satisfaction required.
- Demonstrated ability to take initiative and manage multiple projects simultaneously required.
- Demonstrated commitment to the organization's mission, vision, and values required.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.