Job Summary: The School Based Health Administrator collaborates with other departments and business owners to improve quality of care to CareSource school-age members through implementation of quality initiatives and interventions. Essential Functions:
- Develop and enhance CareSource relationships with school-based health centers (SBHCs) with the goal of providing accessible quality preventive and primary care services to school-aged CareSource members
- Assist SBHCs in identifying gaps in care and expected outcomes in the health status of targeted populations
- Participate in population health quality assurance and improvement activities with SBHCs
- Enhance effectiveness of SBHCs' population health through a variety of member health outcome and quality improvement techniques
- Strategize with SBHCs to develop and enhance the practice's engagement strategies for individual members
- Link SBHCs to internal resources to ensure understanding of all operational and billing processes
- Participate in driving and achieving established HEDIS initiatives as assigned
- Support local presence by participating in community outreach programs/health events, meetings and other opportunities in the community
- Participate in national and/or state school-based health coalitions/ committees and focus groups and provide input on behalf of CareSource regarding any suggested revision(s)
- Participate in internal workgroups/committees to improve quality measures, accreditation and clinical monitoring outcomes
- Assist in the determination of benchmarks, goals and outcomes for all school-based health programs
- Assist in development and implementation of regional plans in collaboration with the regional leadership and population health analytics team
- Identify trends and patterns using standard company processes, reports, tools and databases
- Generate graphics that effectively describe, explore and summarize analyses for communication to appropriate parties
- Provide education on available resources to SBHCs for population health management
- Initiate and maintain ongoing professional contacts with physicians, area health facilities, community organizations and institutions
- Educate and provide information on services, benefits and resources available
- Collaborate to identify areas of opportunity to improve capabilities and partnership processes
- Work independently under general supervision with considerable latitude for initiative and independent judgment
- Look for ways to improve the process to make the members' experience with CareSource easier and share with leadership to make it a standard, repeatable process
- Regular travel to conduct provider visits and community based visits as needed to ensure effective administration of the program
- Perform any other job related instructions as requested
Education and Experience:
- Bachelor's Degree in Health and Human Services, nursing, public health, or related field or equivalent years of relevant work experience is required
- Minimum of three (3) years of experience in nursing, social work, public health or related healthcare field is preferred
- Minimum of three (3) years of experience in school health, community health, Medicaid Managed Care, and/or similar setting is preferred
- Experience working with data and data analytics is preferred
- Experience working directly with providers is preferred
Competencies, Knowledge and Skills:
- Analytic skills for solving problems
- Word, Excel, and/or Access skills are required; SQL and/or SAS experience preferred
- Ability to operate a smart phone, tablet, or other mobile communication devices to ensure productivity and ability to perform essential functions
- Ability to act with diplomacy and sensitivity to cultural diversity
- Strong interpersonal skills and high level of professionalism
- Ability to maintain confidentiality and act in the company's best interest
- Ability to work independently and within a team environment
- Knowledge of quality management/statistical reporting
- Change resiliency
- Excellent conflict resolution skills
- Customer service oriented
- Critical listening and thinking skills
- Excellent written and verbal communication skills
- Knowledge of local, state and Federal laws and regulations
- Knowledge of healthcare resources, benefits and entitlements throughout the state
- Ability to develop, prioritize and accomplish goals
- Proven track record for improving processes to make things easier for those you have served
Licensure and Certification:
- Current unrestricted license in field of practice including (if applicable): Licensed Social Worker (LSW), Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in the State of Service is preferred
- Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated
- To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
- CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Working Conditions:
- Regular travel to different work locations is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time
- A valid driver's license, car, and insurance are necessary for work related travel
- Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
- Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our health partners
Compensation Range: $70,800.00 - $113,200.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds. #LI-JM1
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