Population Health Specialist
Department: Care & Population Health Management
Reports To: Population Health & Community Development Manager
Status: Full time, Non-Exempt
Hours: Monday – Friday
Supervision: This position does not supervise any other staff
Summary: This position is responsible for supporting the efforts and responsibilities of the Population Health Management program. This program focuses on managing care for PrimeWest Health members across the continuum of care to improve health, enhance the care experience, and reduce health care fragmentation, while empowering members to understand and access quality, cost-efficient health care.
Reporting Accountability This position is responsible for meeting the following regulatory, contractual, or other requirements on behalf of PrimeWest Health:
- Complete job duties in accordance with Minnesota Department of Human Services (DHS), Centers for Medicare & Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA) requirements
Role and Key Responsibilities
Assist the Population Health & Community Development Manager and PrimeWest Health staff in the following as needed:
- Administration Answer phones; process mail; and manage/schedule meetings, calendars, appointments, etc. Perform data entry and update spreadsheets, disseminating information as directed Perform other miscellaneous administrative duties including creating and organizing files, copying, faxing, scanning, and mailing as needed
Clinical/Professional Complete follow-up phone calls as assigned for members with identified needs Assist in administering PrimeWest Health’s Focused Wellness (FW) programs Open FW cases from the monthly claims document, make appropriate documentation in CareConnect (CCNT), create letters and mail appropriate educational literature as indicated, enter returned FW questionnaires in CCNT, and close cases as needed Complete FW questionnaires over the phone for identified PrimeWest Health members Fax members’ FW program participation information to providers Send thank-you letters and appropriate educational literature to members who have indicated they want to participate in FW programs Assist in the development and implementation of population health management strategies and programs Implement data-driven population health management strategies under the direction of the Population Health & Community Development Manager and Chief Senior Medical Director Participate in community health and wellness events Represent the PrimeWest Health Care & Population Health Management department at community health and wellness events within the 24-county service area Reports Perform annual satisfaction surveys for Care Management and FW; record results in Excel document Review claims reports to identify trends in utilization
C. General PrimeWest Health Responsibilities
- Abide by the PrimeWest Health Code of Conduct Comply with all PrimeWest Health policies and procedures Comply with the Health Insurance Portability and Accountability Act (HIPAA) and all other privacy laws Be familiar with building safety procedures and alert maintenance if something requires attention Keep public areas of the department and office neat and clean Conduct other responsibilities and activities as needed and assigned
D. Professional Competencies – N/A
E. Educational Requirements and Required Qualifications
- At minimum, Licensed Practical Nurse (LPN) diploma Knowledge of, and proficiency in, Word, Excel, and Outlook required. Experience in relational databases and business information systems is a plus. Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Good verbal and written communication skills. Ability to sit at a desk or computer station most of the time. Ability to occasionally lift and/or carry such articles as file folders and small boxes up to 30 pounds. Ability to travel approximately 20 percent of the time, including overnight travel.
F. Appropriate Licensure and Certification Requirements
- Must possess current and unrestricted LPN license Must attend continuing education sessions each year to support license requirement
G. Collaborative Efforts with Other Departments
- Administration Business IT & Claims Administration Corporate Compliance & Auditing Information Systems & Technology Member & Provider Services Operations Pharmacy Management Quality & Utilization Management
H. Supervision – N/A
This position description is not to be construed as an exhaustive statement of essential functions or responsibilities.
Alexandria, Minnesota – This position offers the possibility for hybrid work.
PrimeWest Health is an Equal Opportunity Employer Committed to Diversity, Equity, and Inclusion