Population Health Specialist I

Description

Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Population Health Specialist I. This individual will provide operational support for the Case, Condition Management, Quality, Wellness, Pharmacy, Government Relations, and Utilization Management Departments. This may include requesting and extracting medical records and provider outreach for HEDIS, Health Risk Assessments, Primary Care Provider Attributions, CIOX medical records, and incoming and outgoing postal mail. The population health specialist I is also responsible for various outbound member calls, including but not limited to new welcome calls, service recovery opportunities, etc.

**This position will be required to work at the Menasha building on a rotating schedule approximately once per month.**

Job Responsibilities:

• Assign case and condition candidates received via referrals/triggers to appropriate Care or Condition Management Coordinator.
• Interact with member, practitioner/provider, or other entities via telephone calls, faxes, emails or letters related to authorizations, case management, claims and benefit inquiries
• Collect member or provider specific information telephonically or electronically as requested.
• Assist in mentoring of new employees as needed.
• May assist with other non-clinical projects and tasks when needed.
• Other duties as assigned

Job Requirements:

• High School Diploma required
• One (1) year of health care experience in clinical or insurance setting preferred.

**This position is eligible to work remote out of your home office in the state of Wisconsin.**

*WARNING: Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that Network Health recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our positions require that you first complete an online application.