Patient Care Advocate
Job Description
Patient Care Advocate
A-Line Staffing is seeking multiple Patient Care Advocates to support Delaware First Health. This is an excellent opportunity for healthcare professionals with experience in patient/member outreach, care coordination, health coaching, social work, or managed care. The role provides an opportunity to directly improve member health outcomes by helping close care gaps and connect members with needed services.
Pay Rate: $30.00/hour
Schedule: Monday–Friday, 8:00 AM–5:00 PM EST
Location: 750 Prides Crossing, Newark, DE 19713
Service Area: Kent County and New Castle County
Position: In-Person / Member-Facing
Highlights
Monday–Friday schedule with no weekends or holidays
No overtime required
Work directly with members and healthcare providers
Support Delaware First Health members with accessing needed care
Conduct both in-person and telephone member outreach
Help identify and close gaps in care
Assist members with barriers such as transportation and appointment scheduling
Collaborative environment with opportunities to work independently
Meaningful opportunity to improve member and provider outcomes
Job Requirements
Requirements
- Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health
- Administration, or a related health field.
- Equivalent work experience may be considered.
- A total of 4 years of relevant experience is required.
- At least 2 years of relevant work experience in direct patient care, social work, quality improvement, health coaching, or a related healthcare setting.
- Strong customer service and communication skills.
- Experience conducting patient or member outreach.
- Experience with care coordination, care-gap closure, patient education, or health coaching.
- Ability to work directly with members and provider offices.
- Strong organizational and documentation skills.
Preferred Qualifications
- Experience working in a managed care environment.
- Experience with Medicaid, Medicare Advantage, or dual-eligible populations.
- RN, LPN, LMSW, LSW, or Certified Social Worker credentials.
- Experience with HEDIS measures, quality improvement, or provider performance.
- Experience coordinating healthcare appointments and community resources.
- Experience addressing transportation or other barriers to care.
Additional Information
Responsibilities
- Act as a liaison and member advocate between members/families, physicians, provider offices, facilities, and agencies.
- Serve as a representative within the provider community and work directly with provider office staff.
- Educate provider practices regarding appropriate HEDIS measures and HEDIS ICD-10/CPT coding in accordance with NCQA requirements.
- Review provider performance data and identify opportunities for improvement.
- Collaborate with Provider Relations to improve provider performance related to
- Quality, Risk Adjustment, Operations, claims, and encounters.
- Conduct outreach to members with identified care gaps.
- Schedule doctor appointments to help members access preventive and other needed healthcare services.
- Conduct face-to-face education with members and their families regarding care gaps and barriers to care.
- Conduct telephone outreach and health coaching to support quality improvement and contractual/regulatory requirements.
- Arrange transportation and follow-up appointments for members as needed.
- Document all member contacts and actions taken.
- Work with departments such as Customer Service to resolve member issues.
- Refer members to case management or disease management when appropriate.
- Complete special assignments and projects supporting departmental goals.
- Travel/work at provider offices throughout Kent County and New Castle County five days per week.