DaVita Patient Relations Specialist- Torrance in TORRANCE, California

Patient Relations Specialist- Torrance

Description

DaVitaMedical Group manages and operates medical groups and affiliated physiciannetworks in California, Nevada, New Mexico, Florida, Colorado and Washington inits pursuit to deliver excellent-quality health care in a dignified andcompassionate manner. As of September 30,2016 DaVita Medical Group (formerlyHealthCare Partners) provided integrated care management for approximately760,000 patients. DaVita Medical Group’s leadership development initiatives andsocial responsibility efforts have been recognized by Fortune, ModernHealthcare, Newsweek and WorldBlu.

We arecommitted to bringing the benefits of coordinated care to our patients and totaking a leading role in the transformation of the national healthcare deliverysystem to assure quality, access, and affordable care for all.

Ifyou're looking to make a difference with a large, financially stable,well-recognized medical group, DaVita Medical Group may be the employer foryou.

Overview :

Responsiblefor conducting various patient and provider outreaches and serving as aresource for the IPA Operations Department.

Essential Functions:

  • Consistently exhibits behavior and communicationskills that demonstrate HealthCare Partners’ (HCP) commitment to superiorcustomer service, including quality, care and concern with each and everyinternal and external customer.

  • Resolves and responds to patient issues in a timelymanner by interfacing with HCP central departments and/or provider offices. Reportssystemic operational issues to the management team.

  • Assists and supports quality initiatives andmeasures

  • Conducts daily review of all grievance files anddatabase logs and performs any necessary follow-up with internal customers andexternal agencies.

  • Produces reports based on database information fortracking, trending and quality of care issues by provider, site or concern.

  • Maintains grievance turnaround time complianceaccording to contractual requirements and reports weekly, monthly, quarterlyand as requested

  • Acts as a liaison, contact person and/or frontlinerepresentative to external HMOs and other agencies and maintains a positive andprofessional relationship with all internal and external staffs and departments(health plans, area hospitals and providers).

  • Maintains confidentiality of all grievance issuesand reports

  • Coordinates outreach mailings to providers andpatients

  • Retrieval and Distribution of new patient lists toprovider offices

  • Makes new patient welcome calls

  • Makes patient calls when physicians terminateadvising them of their new PCP and options

  • Creates results grids as directed that summarizedata, calls, issues, etc

  • Creates tracking grids as directed related to thevarious projects tasked with to ensure that the projects are completed timelyand thoroughly and there is the necessary documentation.

  • Responds to and resolves questions or concerns frompatients or staff in a timely and service oriented manner.

  • Uses, protects, and discloses HCP patients’protected health information (PHI) only in accordance with Health InsurancePortability and Accountability Act (HIPAA) standards.

  • Assists with departmental projects and studies asrequested

  • Performs additional duties as assigned.

Qualifications

EDUCATION:

  • Oneor two years of post-high school education or a degree from a two-year college.

  • Bachelor’sdegree preferred.

EXPERIENCE:

  • Over1 year and up to and including 3 years of experience.

  • Priorexperience in a health plan, medical group or IPA setting working withphysician networks.

  • Customerservice experience.

KNOWLEDGE,SKILLS, ABILITIES:

  • Computerliterate.

  • MicrosoftOffice applications skills (Word, Excel).

  • Goodunderstanding of HMO systems provider reimbursement mechanisms.

  • Knowledgeof CPT-4 and ICD-10 coding systems.

  • Excellentverbal and written communication skills.

  • Abilityto interface with all levels of management

  • Strongcustomer service and interpersonal skills.

  • Abilityto write letters and articles.

Primary Location CA-TORRANCE - 90504

Req ID: 307151