Care Navigator, Population Health

Population Health Quality Management supports Population Health initiatives to increase the quality of care, while maintaining cost-effective outcomes through targeted patient outreach and care gap closure. The Care Navigator is responsible for medical record abstraction and outreach activities in support of maintaining and enhancing performance on quality measures in an ambulatory environment. This includes HEDIS and other value-based care quality, cost, and utilization measures.

The Care Navigator will utilize standardized training materials to collect medical records that meet HEDIS specifications and facilitate outreach to complete gap closure activities. Outreach responsibilities include conducting and answering telephone calls, re-directing calls as appropriate, scheduling visits, and assisting patients with questions or concerns. A goal of this role is to close care gaps by maximizing medical record retrieval for quality measures (e.g. screening, immunization, and medication adherence) and create intervention-oriented reports that identify members in need of service gap closures.

Salary Range: $22.03-$43.68/hourly

Required:

• Prior experience in population health or managed cared equivalent quality management programs
• Knowledge of Federal, State and local regulations and laws, including, but not limited to NCQA, HEDIS, CMS and DMHC as well as health plan standards and delegation requirements as they relate to quality management
• Ability to utilize Word, Excel and other software programs
• Ability to establish and maintain cooperative and collaborative working relationships with administrative, clinical and academic personnel
• Skill in working independently and following through with minimum direction
• Ability to set priorities
• Demonstrate writing skills to compose logical, detailed and grammatically correct correspondence
• Document patient care in a concise and comprehensive manner
• Excellent assessment skills required
• Knowledge of efficient interviewing practices and techniques used in order to gather information
• Strong interpersonal skills with the ability to build relationships with providers and patients
• Excellent verbal and listening skills both in-person and on the phone required
• Excellent customer service skills required. Ability to be culturally sensitive and work with a diverse, geriatric patient population
• Knowledge of medical records and appropriate documentation requirements.
• Ability to maintain patient confidentiality required. Knowledge of HIPAA requirements
• Ability to remain calm and be resourceful in emergency situations required
• Ability to maintain a professional demeanor at all times

UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.