Health and Wellness Specialist

NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND

 

POSITION DESCRIPTION

 

POSITION TITLE: Health & Wellness Specialist     DEPARTMENT: Medical Management

 

REPORTS TO:  Manager, Quality & Outreach     HOURS:  37.5

       REVIEW TYPE: * 6 Month T Annual FLSA:  * Non-Exempt T Exempt   

SALARY GRADE: 12 HIERARCHY GROUP:  Salary / Exempt /

Staff Member

 

EEOC CODE:    WORKERS COMP CODE:

Position Summary:  Promote, maintain and improve individual and community health by assisting NHPRI

members, communities and providers adopt and support healthy behaviors.

 

Qualifications:

?  Bachelor of Science Degree required, Masters in Public Health or Health Service Administration preferred

?  Registered Nurse licensed in RI preferred

?  Minimum 3-5 years experience in managed care organization, or health care related organization

?  Experience in managing quality improvement projects

?  Experience in managing health and wellness projects

?  NCQA and HEDIS experience preferred

?  Intermediate / advanced Microsoft Word & Excel

?  Proven quantitative and analytic capability

?  Excellent oral and written communication skills

?  Strong organizational and documentation skills

?  Excellent customer service orientation

?  Strong interpersonal skills

 Duties and

Responsibilities:

 

Responsibilities include, but are not limited to, the following:

?  Collect and analyze data to identify community needs prior to planning, implementing, monitoring and evaluating programs designed to encourage healthy lifestyles, policies and environments

?  Oversee quality improvement projects including: analysis of data, develop and implement interventions, arrange and facilitate meetings with network clinicians and key community agencies, document activities, and collection of data as needed to support projects

?  Participate in quality management provider meetings.  Support planning, collaboration with internal departments, and development of materials for provider meetings 

?  Management of existing Health & Wellness Outreach Management Programs.  Programs include asthma, diabetes, smoking cessation, high-risk pregnancy, and obesity.

?  Coordination with key departments, including Marketing, and Member Services. 

?  Development of strategic plan for NHPRI?s Health & Wellness Outreach Program

?  Development of new Health & Wellness Outreach Programs based on data evaluation

?  Collaboration with State Agencies, network providers, regional health plans on Health & Wellness Outreach initiatives

?  Collaboration with community partners including community health centers, Department of Health, and the Rhode Island Health Center Association

?  Report and present to provider and member Advisory Groups, Clinical Affairs Committee and Quality Improvement Committee and other forums as deemed appropriate

?  Support Medical Management in NCQA Accreditation preparation

?  Health & Wellness Outreach Projects as assigned

?  Take responsibility for professional development, support a learning environment, and meets professional competency requirements

?  Participate in department continuous quality improvement activities

?  Other duties as assigned by manager

NHPRI is an Equal Opportunity Employer