Team Lead Quality Outreach Unit Representative

Job Details

The Quality Improvement and Performance (QIP) Team Lead works with minimal supervision to oversee QIP Outreach teams, who conduct telephonic outreach to JHP membership. This role helps to ensure that Quality Outreach Representatives are effectively engaging members, meeting performance goals, and aligning with organizational quality improvement initiatives including STARS, HEDIS, NCQA Accreditation and member satisfaction goals. The ideal candidate is a results-driven leader with strong coaching, communication, and problem-solving skills.

Job Description

Essential Functions

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Performs the duties of Quality Outreach Representatives and provides support to other Outreach Reps performing outbound calls for QIP campaigns
• Creates/assigns work files and summarizes campaign results
• Assists QIP leadership with special projects and outreach campaigns as needed.
• Helps to develop and attain QIP strategic goals, including HEDIS, STARS, and NCQA Accreditation.
• Provides coaching, training and ongoing development to enhance staff skills and effectiveness.
• Serves as a resource for team members, troubleshooting member engagement barriers, provider scheduling barriers, and workflow issues.
• Conducts regular team meetings and one-on-one check-ins to review progress, challenges and to share best practices in collaboration with Supervisor, QIP.
• Works on-site and attends community events as needed.
• Assists with onboarding new staff members and coordinating training
• Assists with the development and refinement of departmental policies and procedures.
• Attends company-wide and departmental meetings as requested and when authorized.
• Understand the role of and support the Community Health Navigators, as needed
• Provides coverage and supervision to staff in management’s absence.
• Creates QIP Staff Meeting minutes and records attendance.
• Assists with reporting (Salesforce/Qlik)
• Assist with new system implementation, user training and testing
  
  

Competencies (Knowledge, Skills, And Abilities Required)

• Strong knowledge of Medicare/Medicaid populations, preventive screenings, and social determinants of health (SDOH)
• Presents professional image and confidently demonstrates working knowledge of QIP, JHP and Jefferson Enterprise
• Has a proven track record of taking initiative and working independently on new processes with minimal supervision.
• Demonstrated history of utilizing critical thinking skills and judgment, applying prior knowledge and experience.
  
  

Education

Minimum Education and Experience Requirements:

High School diploma or equivalent

Experience

Leadership experience in healthcare, managed care, call centers or community outreach preferred.

Prior experience in HEDIS, STARS, quality improvement, or member outreach.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.