Medicare Special Needs Coordinator
PacificSource

Springfield, Oregon

Posted in Insurance


This job has expired.

Job Info


Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Position Overview: Oversee initiatives aimed at enhancing member experience and the health of members in Medicare Dual Special Needs Plan (DSNP), including the Member Advisory and DSNP Member Advisory Oversight Committee. This role provides both internal and community-based project management and coordination to advance the health, access to care, coordination of services, health equity for underserved populations and member experience. This position works closely with community partners, members, and local government entities. This position requires that the majority of time be spent in Central Oregon and Lane County.

Essential Responsibilities:

  • Contribute to PacificSource's member experience initiatives through their conception, development, and implementation. Interact with all departments and personnel, as needed, including external customers, providers, government entities, community partners, vendors, and consultants.
  • Contribute to, design, and implement work plans generated from the DSNP Member Advisory and the DSNP Oversight Committee, and the Member Experience Plan. Responsible for understanding the member journey and leading key stakeholders to understand the impact of initiatives on member engagement and improvement.
  • Develop business plans and monitor contractual agreements for collaborative community and member experience projects, ensuring that successful initiatives have a positive impact on both the organization, and the member. Lead project management role for some initiatives.
  • Facilitate multi-stakeholder groups in the development and execution of complex projects.
  • Develop effective solutions and manage schedule, timelines, activities, and milestones to ensure thorough development and timely implementation of projects.
  • Facilitate and represent the company at the DSNP Member Advisory Committee and work groups to establish common solutions to complex member health problems thus improving health and coordinated care.
  • Work with internal and external stakeholders to develop project plan, including plans that will improve care for complex, vulnerable populations.
  • Participate in other local community health initiatives not sponsored by the company.
  • Partner with leaders and staff to ensure member experience plan strategies are aligned, best practices are shared, and teams are well informed about how to leverage community health plan and member experience initiatives in their daily work.
  • Coordinate business activities by maintaining collaborative partnerships with key departments. Coordinate services for events, such as accommodation and transportation for participants, facilities, food, materials, and special needs requirements. Actively participate in various internal and external committees to disseminate information within the organization and represent company philosophy.
  • Recruit DSNP Members for DSNP Member Advisory. Be the liaison between the committee member and Pacificsource. Create meeting materials, project plans and follow-up for committee members. Interreacting with members and staff to resolve member issues and direct members to the appropriate resources.
  • Provide project management support for the Medicare Program Manager and VP of Medicare, as needed.

Supporting Responsibilities:
  • Collaborate with and enhance relationships with community partners in support for member outreach and engagement, and CCO Community Health Coordinators.
  • Participation in internal and community based public presentations.
  • Provide thought leadership and participate directly in refinement of the company's strategic plan and major strategic aims.
  • Educate departments and employees on the DSNP and Member Experience Improvement Plan strategies.
  • Meet department and company performance and attendance expectations.
  • Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  • Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: Minimum of 5 years' experience in the health care industry, provider organization, or related area. Experience in Medicare and Medicaid preferred. Relevant experience in the following areas: managing healthcare operations, customer experience, community health, strategic planning, business development, quality improvement, strategic relationship development, workforce innovation, population health improvement. Experience leading large multi-stakeholder initiatives highly desired. Experience in managing complex projects or project management certification is desirable. Demonstrated ability to develop and execute strategy.

Education, Certificates, Licenses: Bachelors or equivalent degree strongly preferred in Public Health, Social Worker, Healthcare Administration, Business, or related field. PMP certification preferred.

Knowledge: Excellent public relations, presentation, and interpersonal skills. Demonstrated successful communication skills, including public presentation, training, meeting facilitation. Strong verbal and writing skills. Maintain high level of knowledge of company products, health reform trends at the Federal and State levels, and the insurance industry. Demonstrated skills with the following software: Microsoft Word, PowerPoint, Excel, and Visio. Strong analytical and problem-solving skills.

Competencies
  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 35% of the time.

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for customer service.
  • We practice open communication at all levels of the company to foster individual, team and company growth.
  • We actively participate in efforts to improve our many communities-internally and externally.
  • We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
  • We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.


This job has expired.

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