Better Health Group Hiring for Healthcare ACO Customer Service Representative (Remote) at Tampa, FL Full Time

What’s Your Why?

• Are you looking for a career opportunity that will help you grow personally and professionally?
• Do you have a passion for helping others achieve Better Health?
• Are you ready to join a growing team that shares your mission?

Why Join Our Team: At Votion, it’s our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! We don’t just talk the talk – we believe in it and live by it. Our core value is always to deliver 5-star service. And by doing so, we successfully achieve our mission of Better Health. We support our providers with all the necessary tools and resources they need to deliver the care all patients deserve. Be part of a team that is rebuilding sick care into Better Health Care. We take great care of our team, patients, providers, and affiliates because together, we can achieve: Better Care. Better Outcomes. Better Health

THE OPPORTUNITY

This Team Member will perform administrative, clerical, and operational duties in collaboration with medical office teams, internal teams, and external community resources to support care goals and the Health Services Team function as designated by Better Health Group.

Responsibilities & Experience

The National Products Health Coach, primarily responsible for the ACO program, will directly support the Health Services Team through Annual Well Visit Scheduling and Transition of Care Management. They will be expected to perform within the following scope, as well as other assigned duties and activities that aid and leverage our Team function. Responsibilities include and are not limited to:

• Communicating and facilitating Transition of Care Management (TCM) telephonically between ACO Traditional Medicare patients and medical offices as assigned
• Telephonic outreach to recently discharged patients; to assess patient needs and coordinate care
• Thorough interview of assigned patients regarding discharge instructions and plans including but not limited to:
• Educating patients to call Primary Care Physician (PCP) for all truly non-emergent services
• Inquiring as to discharge planning and review of plan with Provider
• Encourage and schedule post-discharge medication reconciliation with the Provider
• Review any dietary changes with the Provider post-discharge
• Review any self-care planned i.e.: durable medical equipment, home care, wound care, etc.
• Assess patient at-home support system ie: caregiver or any persons identified as assisting them with any healthcare needs
• Establishing whether or not the patient has advanced directives in place and accessible to the Provider and family in case of need (encouragement to do so, if not)
• Obtaining the status of seasonal vaccines
• Scheduling or confirming follow-up with Provider, ideally within 7 days of discharge
• Utilize program benefits effectively; transportation assistance, nutritional support, and other benefits as applicable
• Responsible for ing on TCM task completion and disposition of tasks as appropriate
• Accurate and timely documentation provided to assigned PCP office champions
• Prepared to assist with telephonic outreach to external pharmacies, PCPs, and patients for medication adherence
• Prepared to assist and engage in other telephonic outreach campaigns as directed by Better Health Group, including Medicaid, Medicare, fee for service, etc.
• Utilizing TCM s to prevent re-admissions for recently discharged patients
• Utilizing Complex Care Management s to identify patients at risk for admission to hospital and strategize on preventative care options
• Escalate high-risk patients to medical office champions, internal Utilization Management Nurses, internal Subacute Nurses, and internal Field Ops team members as appropriate
• Daily operation of a multi-line phone system to complete assigned tasks and management of inbound and outbound calls
• Daily operation and utilization of designated electronic medical systems for task completion and accurate documentation of call activities
• Act as liaison to encourage and empower patients to utilize primary care or Urgent Care services in lieu of Emergency Room and Hospital, when appropriate
• Collaborate with internal and external teams to leverage care goals
• Communicate with medical office champions to monitor care provided to high-risk patients
• Conduct outbound calls to ACO recipient patients to schedule annual wellness visit exams.
• Clearly explain the purpose of the call and provide detailed information about the importance of the wellness exam.
• Assist patients in understanding any specific requirements for their appointments.
• Ensure accurate and up-to-date information is collected during the call, including patient demographics, insurance details, and scheduling preferences, documenting in internal systems and clinic medical record systems where allowed
• Document and track progress using provided systems, tools, or resources
• Maintain a professional and courteous demeanor while interacting with patients and their families, addressing any questions or concerns they may have using approved or reasonable and accurate information
• Collaborate with healthcare providers and clinics to schedule appointments directly into their EMR system, ensuring accurate and timely scheduling with the goal of improving patient health outcomes and the closure of Quality Care Measures.
• Stay updated on ACO CMS regulations including but not limited to the MSSP program specifically policies and procedures as communicated by Votion to provide accurate information and navigate any policy changes effectively.
• Meet individual and team performance targets for call volume and appointment scheduling
• Adhere to protocols, including quality standards, call scripts, and compliance with privacy regulations.
• Attend and participate in recurring Health Services meetings with immediate Team and cross-functional stakeholders
• Attend and participate in recurring 1:1 meetings with the Director of Health Services, Manager, Team Lead, and Quality Assurance Specialist
• Build lasting relationships with medical office teams and obtain consistent engagement/participation from assigned offices in support of Votion programs and initiatives
• Other designated administrative, clerical, or operational tasks as assigned to leverage Better Health Group goals (i.e.: medication adherence initiatives, PODS, members not seen, etc.)

Key Attributes:

• Has a contagious and positive work ethic, inspires others, and model the behaviors of our core values and guiding principles
• An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments.
• Is able to work within our Better Health environment by facing tasks and challenges with energy and passion.
• Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals.
• Demonstrated ability to handle data with confidentiality

Additional EDUCATION & SKILLS Preferred:

• Technical degree and experience preferred
• At least 2 years of experience in a healthcare environment
• At least 1 year in a call center environment preferred
• Ability to successfully navigate electronic medical systems for accurate documentation and data purposes
• Demonstrated ability to engage telephonically with patients and external care teams
• Proven ability to manage and coordinate inbound and outbound telephonic outreach
• Proven ability to work with Google Suite software or equivalent (MS Excel and MS PowerPoint)
• Ability to work independently with minimal supervision
• Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
• Demonstrated resourcefulness, initiative, and results-oriented capabilities
• Ability to work in a shifting and fast-paced environment
• Must be able to work professionally with confidential information
• Excellent written and verbal communication skills.
• Ability to work cross-functionally with multiple teams
• Ability to shift focus, multi-task, and prioritize in a rapidly changing environment.
• STRONG reasoning and critical thinking are required.
• MUST be results-oriented with a focus on quality execution and delivery.

Physical Requirements:

(essential function: telephone, communication, operative, sit – long periods of time)

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