Job Description
TrueCare is a Mississippi non-profit, provider-sponsored health plan formed by a coalition of Mississippi hospitals and health systems throughout the state and supported by CareSource ’s national leadership in quality and operational excellence. TrueCare offers locally based provider services through provider engagement representatives and customer care. Our sole mission is to improve the health of Mississippians by leveraging local physician experience to inform decision-making, aligning incentives, using data more effectively, and reducing friction between the delivery and financing of health care. By doing so, TrueCare will change the way health care is delivered in Mississippi. Job Summary: The Prevention Health Specialist is responsible for assisting and educating both members and providers on appropriate preventive health services to ensure compliance to state and federal guidelines and improved health outcomes. Essential Functions: Ensure that members eligible for Medicaid benefits receive outreach for informing, screening, tracking, diagnostic and treatment services available under the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit Responsible for execution, monitoring and reporting of Quality or Preventive Health Programs and strategies (i.e., School Based Health Centers, Telehealth), including supporting members with educational materials according to clinical best practice guidance Participate in quarterly market Quality Improvement and population health management workgroups Facilitate completion of the annual evaluation report for assigned market/product Attend telephonic Health Partner meetings with top providers; engage in population and rural provider strategy Telephonically contact eligible members and providers to discuss all preventive care needs, benefits and their current gaps in care Ensure that contractual/regulatory requirements for prevention services are met Collaborate with enterprise quality for all preven
