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.

The Health Programs Coordinator oversees PacificSource Health Management Programs and/or oversees PacificSource vendor and external health program relationships. Primary responsibilities will be to analyze current external program and vendor performance and optimize vendor solutions to facilitate an enhanced member experience.

Essential Responsibilities:

Assist Case Management (CM), Wellness or Program Manager with disease, wellness and prevention program management, as needed, to identify ways to optimize member experience, health outcomes and program performance.Assist with vendor management, as needed, to identify ways to optimize value and performance.Understand and participate in the PacificSource contract process. Keep track of contract requirements, specifications, dates, and timelinesContact (written and telephonic) with vendors, as directed and independently, including paperwork and invoices related to any outsourced relationship.Understand and participate in the PacificSource RFI process.Contact (written and telephonic) with members, as directed and independently.Assist in coordinating projects under direction of the project manager or ManagerSupport Leader Standard Work through setting goals and metrics, visual management, idea boards and huddles.Review current internal programs with CM and Wellness Manager and other stakeholders and analyze if they meet PacificSource needs.Attend regular program related meetings. Include internal stake holders and subject matter experts where appropriate.Accountable for timely and accurate completion of regulatory activities. Formulate strategies, monitor progress, and report out program risks, results and present recommendations to leadership.Assist program manager or leadership with program research for program enhancement.Participate in the phone queue for member questions, assessments, and scheduling of coaching sessions.Participate in outbound calls when required: member call back, rescheduling, etc.When applicable enter and follow PacificSource member customer service tickets, advocate on members behalf.Back up the other Health Programs Coordinators.

Supporting Responsibilities:

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 2 years of experience in health and/or disease management. Background in health plan medical management desired.

Education, Certificates, Licenses: High school diploma or equivalent required.

Knowledge: Knowledge and understanding of medical procedures and terminology, diagnoses, care modalities, procedure codes, including ICD-10, CPT Codes. Strong communication skills, in written and verbal formats. Ability to deal with a diverse population consisting of members, providers, and community partners. Strong organizational skills and experience with Microsoft Office programs and medical management software. Ability to use audio-visual equipment. Ability to work independently at times with minimal supervision.

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 5% of the time.

Skills:

Accountability, Communication, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork

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.