[Remote] Quality Specialist II

Note: The job is a remote job and is open to candidates in USA. True Health is dedicated to providing high-quality services to their patients, and they are seeking a Quality Specialist II to coordinate therapeutic services and improve patient care. The role involves planning with patients and healthcare teams, educating patients about treatment options, and advocating for positive health outcomes. Responsibilities • Plan with the patient, family/caregiver, primary care provider, support staff, payers, and the community resources, to maximize healthcare responses, quality, and cost-effective outcomes • Facilitate communication and coordination between members of the healthcare team, involve the patient in the decision-making process to minimize fragmentation in the services • Educate the patient, family or caregiver, and members of the healthcare delivery team about treatment options, community resources, insurance benefits, psychosocial concerns, care coordination, etc., so that timely and informed decisions can be made • Empower the patient to problem-solve by exploring options of care, when available, and alternative plans, when necessary, to achieve desired outcomes • Encourage the appropriate use of healthcare services and strive to improve quality of care and maintain cost effectiveness on a case-by-case basis • Assist the patient in the safe transitioning of care to the next most appropriate level • Strive to promote patient self-advocacy and self-determination • Advocate for the patient to facilitate positive outcomes for the patient, health care team, and payers • Attending monthly meetings with insurance payers to have a consistent line of communication open and assist with setting goals for quality improvement • Work on projects as assigned based on priorities received from insurance companies • Stay involved and active with quality improvement activities • Conduct chart audits to determine quality compliance and documentation opportunities • Proficient in clinical knowledge to aid other non-clinical colleagues with closing care gaps as needed • Other projects/duties as assigned Skills • Current Florida LPN License, active and in good standing • One (1) year minimum experience in Clinical Care Coordination, Care Planning or Chronic Care Management • Computer competency is required • One (1) year minimum experience with an EHR (Athena Health preferred) • Must be a collaborator but able to work independently • Excellent spoken and written communications skills • Must have reliable transportation • Ability to view a computer screen for extended periods of time • Ability to perform repetitive hand and wrist motions for extended periods of time • Ability to communicate effectively with patients and staff • Certified Medical Assistant active and in good standing • Bilingual is a plus (English/Spanish) Company Overview • True Health is a non-profit patient-centered medical home serving the community . It was founded in 1977, and is headquartered in Sanford, Florida, USA, with a workforce of 201-500 employees. Its website is https://mytruehealth.org. Apply tot his job Apply To this Job