Population Health Advisor

 Collaborates with analytics, quality, and payer program management to facilitate care coordination of at risk populations

 Self Manages daily workflow and patient engagement schedule

 Engages identified impactable population for care coordination

 Follows established workflows for care Coordination 

 Identifies gaps in care and opportunities for patients to improve or maintain health

 Supports Patient in setting attainable health goals to effectively self-manage

 Advises patient on benefits of effective self-management

 Encourages Patient to Follow Provider and Patient Plan of Care to achieve goals

 Establishes consistent contact with patients to facilitate behavior change, self-management, goal setting and progress with patient plan of care

 Encourages and reinforces healthy self-management behaviors

 Supports financial goals of the managed care organization

 Collaborates with clinical team and community resources to facilitate patient self-management, address gaps in care, and goal setting

 Provides education and resources to patients and families on chronic conditions or identified care needs

Competent in basic computer skills (including Microsoft Office-Word, Excel, a0nd Power Point); knowledge of using an electronic health records system preferred.

Demonstrate superior organizational & interpersonal skills; will be detail oriented; will have proven ability to work collaboratively, and be able to multi-task.