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Program Coordinator

Program Coordinator

HealthfirstRochester, NY, US
3 days ago
Job type
  • Full-time
Job description

Program Coordinator, Reward Card Program in Clinical Quality

The Program Coordinator, Reward Card Program in Clinical Quality is responsible for supporting Healthfirst initiatives and regulatory requirements related to Member Rewards and Incentives, HEDIS Quality Improvement, Medicare Stars and Member Satisfaction. This position is both internal (EDS, Marketing, etc.) and external (Members, Provider, Vendor) facing.

Duties & Responsibilities :

  • Verifies reward requests based on required preventive services appropriate for the member's age, gender and other accepted demographics as outlined via the Member Reward Card Program Guidelines, HEDIS / QARR Technical Specifications, and CMS / DOH guidelines
  • Conducts member and provider outreach to inform on reward guidance and status using multiple internal systems and applications
  • Collaborates with internal and external teams to track and document program requirements and implementation status
  • Documents, communicates and presents technical improvement findings and recommendations in all systems supporting Member Rewards Program
  • Provides support in creating, editing and communicating member and provider material updates
  • Additional duties as necessary

Minimum Qualifications :

  • High School / GED Diploma from an accredited institution
  • Basic knowledge of MS Word, Excel, Access, and Outlook
  • Strong organizational skills
  • Good communication (verbal and written) and interpersonal skills
  • Flexibility, reliability, and easily adaptable to any work assignments or new computer applications
  • Competent in managing responsibilities in a high-volume and fast-paced environment
  • Ability to resolve member issues with patience and courtesy
  • Preferred Qualifications :

  • Associate's degree from an accredited institution + 2 Years Work Experience.
  • Experience processing reward card requests highly preferred.
  • Bilingual in English and one or more language(s) : Spanish, Mandarin, Cantonese may be required based on business needs
  • Familiarity with some medical terminology.
  • Experience addressing member inquiries in a managed care environment.
  • Knowledge of CPT and ICD-9 codes.
  • HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and / or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

    All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

    Hiring Range

  • Greater New York City Area (NY, NJ, CT residents) : $39,208 - $52,000
  • All Other Locations (within approved locations) : $34,091 - $49,920
  • As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

    In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements).

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    Program Coordinator • Rochester, NY, US

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