- Provider Practice Engagement & Communication and Relationship Building
- Manages patient gaps in care by establishing efficient and effective workflows between providers, patients, and HMSA.
- Accountable for establishing and maintaining sustained engagement within practices that impacts costs, quality, access, and overall patient experience through the deployment of tactical and strategic methodologies.
- Build and effectively maintain strong relationships with practice operational and clinical leadership that informs development of performance improvement initiatives to achieve identified goals.
- Supports ongoing physician -- patient relationships by providing educational and operational support to improve the quality, access, and satisfaction of the patient experience. Includes the development and delivery of a streamlined process for the practice to access additional educational and behavioral change tools, as appropriate.
- Actively conducts physician-patient outreach which may include telephonic, face-to-face or via email.
- Leads ad-hoc projects/assignments and actively participate in all internal and external meetings.
- Member Engagement
- Engages with members on both inbound and outbound calls to establish trust, credibility and drive improved health and well-being.
- Provides initial engagement to member who self-refer or are referred by their physician or facility or participate in appropriate intervention.
- Utilize effective communication skills such as motivational interviewing to gain agreement from member to be compliant with routine provider appointments, recommended screenings, vaccinations, etc.
- Collaborate with physicians, office staff, and HMSA team members to address and/or close gaps in care.
- Problem Solving and Process Improvement
- Assess and communicate provider capabilities to inform future interventions; work with the HMSA LOB PO teams as needed.
- Use internal and external data to analyze and interpret trends. Work with appropriate stakeholders to implement proactive strategies to address issues and measure impact.
- Develop and deploy localized practice optimization strategies based on data analysis that includes measurable and time-specific aim statements as part of a data-informed PDSA rapid cycle optimization approach.
- Function as a change agent by promoting workflow efficiencies, best practices, and other change management tactics that improve patient-centered care, timely access to care, and population health management.
- Facilitates communication and requests among multi-disciplinary team members, providers, health plan, and members.
- Coordinates data extracts and data analysis interpretation in preparation of reports aimed to determine the effectiveness of programs for the assigned PO/providers.
- Develops and deploys workflow optimization and training efforts for provider office staff in a changing and evolving healthcare operating environment. This position requires high level of autonomy in decision making.
- Maintains a deep understanding of HMSA performance measure requirements.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
- This may include projects and pilots that align with HMSA corporate goals, and internal and external metrics and deliverables, including employer groups, business partners, and CMS. For example:
- HMSA-IHMS-MOC assignments, training, meetings, and events
- Employer group pilot programs and health fairs
- Care coordination and care gap closure as identified through various projects and pilots.
- Medical record and/or clinical data collection
#LI-Hybrid
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HMSA
Jun 03, 2026