EPSDT Coordinator – Maryland Heights, MO (833407)

Position Description

Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you’ll have the opportunity to make an impact on a huge scale. This is the place to do your life’s best work.(sm)

This position is responsible for coordination of care for the EPSDT aged members to meet EPSDT quality and performance measure goals. You would be responsible for direction and guidance on clinical quality improvement and management of well child performance improvement measures. Responsible for the development and implementation of data collection methodology to meet or exceed minimum performance standards established by the regulator, reporting and analysis of clinical performance measures and state required regulatory performance improvement projects (PIP). This position serves as health plan resource for the EPSDT / Well Child Program.

Job Components

• Targeted Quality Improvement
• Gaps in Care Closure
• Relationship Management, Internal and External
• Community Engagement and Interaction
• Provider and Practice Education, Quality Oriented Health Topics

Primary Responsibilities:

• Plan, organize and coordinate all aspects of the EPSDT program, ensuring compliance of EPSDT with all state and federal requirements and NCQA standards
• Facilitate outreach to encourage parents/guardians to help members access preventive care, assist with making appointments/arrangements, as necessary
• Assist in education of members regarding health conditions, available benefits and providers, health plan services and EPSDT special services available
• Recommend and evaluate potential incentive programs for components of the EPSDT program
• In conjunction with the nurses monitor and report on provider compliance with the EPSDT program
• Develop educational materials and/or provide training to providers and/or members
• Collaborate with and communicate to providers the importance of all aspects of the EPSDT program, including blood testing, immunization schedules and periodicity schedule compliance
• Report quarterly EPSDT calls and letter outreach rates at Quality Management committee
• Collaborate with the Quality Director, CMO, and others to effectively manage the EPSDT membership
• Coordinate with other health plan departments to strategize improvement plan interventions and appropriate outreach activities
• Participate in the implementation of any required newly developed health initiatives concerning EPSDT.
• Work with care managers to help EPSDT-eligible children access (directly or through referral) to corrective treatment or early intervention services, depending on member-specific developmental needs
• Make quarterly visits to provider offices for EPSDT education and gap closure

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

Required Qualifications:

• Associates Degree
• 2+ years healthcare experience
• 2+ years of experience working with quality improvement activities
• Knowledge of Federal and State regulations and guidelines applicable to Child and Teen checkups and other Public Health programs

Preferred Qualifications:

• RN licensure or Health Education background
• Experience working for a Medicaid and/or Medicare health care regulator or insurance organization

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life’s best work. (sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Quality Improvement, EPSDT, Public Health, UnitedHealth Group, UHG, Maryland Heights, MO, Missouri