Health Care Specialist Job Description
Health care specialist
provides hands-on involvement in concurrent clinical reviews, core measure abstraction, denial management, readmission reviews, Patient Review Instrument completions, CDI, staff education and other case management duties of the department as needed.
Health Care Specialist Duties & Responsibilities
To write an effective health care specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included health care specialist job description templates that you can modify and use.
Sample responsibilities for this position include:
Partner remains flexible to changing systems, is expected to demonstrate quality and effectiveness in work habits and treats staff, physicians, patients and families with consideration and respect
Manages daily behavioral groups and group activities
Assists in monitoring the behavior and activities of each client
Ensures compliance with safety measures
Provides clients with training and/or assistance with daily living skills
Directs and implements individual service/treatment plans in collaboration with the therapeutic team
Documents all interventions appropriately
Provides a safe environment for all patients
Completes hand off process
Contributes to the monitoring of quality patient care
Health Care Specialist Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Health Care Specialist
List any licenses or certifications required by the position: BLS, CHES, ASCP, CPR, MLT, PBT, CPI, ACLS, CNS, CDCES
Education for Health Care Specialist
Typically a job would require a certain level of education.
Employers hiring for the health care specialist job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Education, Health, Social Work, Psychology, Department of Education, Healthcare, Public Health, Health Care, Graduate Education, Human Services
Skills for Health Care Specialist
Desired skills for health care specialist include:
Poison center policy and procedure manual
Research Institutional Review Boards
Abstraction
Aggregation
Analysis
Another official UN language
Clinical chart review and abstraction
Excel
Experience in delivery of medical and non-medical case management
French
Desired experience for health care specialist includes:
Experience in behavioral health field a plus
Must have a valid driver's license as travel is essential
Successful sales experience within competitive markets
Experience in the home health market
History of demonstrated sales success in achieving and exceeding sales targets preferred
Maintains confidentiality of patient related information
Health Care Specialist Examples
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Health Care Specialist Job Description
Job Description Example
Our company is growing rapidly and is hiring for a health care specialist. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for health care specialist
- Contributes to the smooth operation of the Behavioral Health unit
- Performs other duties as permitted by licensure, credentialing or training
- Performs general office duties as directed by immediate supervisor
- Maintains 100% compliance with mandatory competency training within established time frame
- Associates degree in Mental health or related field is required
- A Bachelors degree in Mental Health or related field or a graduate from an accredited school of nursing with a valid Licensed Practical Nurse State of Florida nursing license is preferred
- A minimum of two (2) years of related experience in an acute care psychiatric setting is preferred or LPN
- Work with patients to ensure their identified community resource needs are met legal, financial or other
- Review physician and hospital claims, membership enrollment applications, and provider additions and/or changes
- May work on complex projects such as focus audits or other projects as identified
Qualifications for health care specialist
- Working knowledge in health care systems
- Certified nurse assistant or certified medical assistant
- Ability to do electronic documentation
- Lead Quality Assurance (QA) processes associated with data feeds for monthly release
- Overall Systems Development Life Cycle understanding specific to Quality Assurance (QA) testing
- Knowledge of standard QA application
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Health Care Specialist Job Description
Job Description Example
Our innovative and growing company is looking for a health care specialist. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for health care specialist
- Perform comprehensive behavioral health assessments
- Document findings consistent with Optum and Center for Medicare and Medicaid Services (CMS) regulations
- Facilitate agreement and implementation of the member’s plan of care by engaging the care team
- Assures that the aligns with the member’s needs and wishes
- Coordinate care as member’s transition through different levels of care and care settings
- Includes the expertise of social work and other disciplines in care plan
- Assess the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change
- Evaluate plan of care for cost effectiveness while meeting the needs of members, families and providers to decreases high costs, poor outcomes and unnecessary hospitalization
- Actively promote the Optum programs by partnering with key stakeholders to maintain and develop membership caseload
- Exhibit original thinking and creativity in the development of new and improved methods and approaches to behavioral health in the LTC setting
Qualifications for health care specialist
- Capable of writing and understanding advance Structure Query Language (SQL) concepts
- Knowledge of healthcare claims, eligibility and provider data
- Understanding of Business Intelligence tools
- Capable of performing in-depth analytics on large data sets
- Ability to communicate with numerous groups, perform multiple tasks within a specific timeline and follow through on initiatives as needed
- Experience in communicating with various management levels
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Health Care Specialist Job Description
Job Description Example
Our innovative and growing company is hiring for a health care specialist. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for health care specialist
- Assume position of key technical lead for a specific technology area
- Become recognized internally as an authority in a defined technology area, particularly in the development of purified excipients and new and changed purification processes
- Allocate short and medium term projects (from a few days to more than one year) to self and other members of the team as necessary
- Plan, execute, monitor/report progress of, and deliver delegated projects and updates on time
- Enhance knowledge of market areas and relevant scientific techniques, communicate with the business as appropriate, build relationships with key technical decision makers and influencers, and identify opportunities for new projects
- In line with individual development within the role, take on customer orientated activities (eg
- Provide high level technical support to customers and/or internally to develop solutions to customer problems
- In some cases the role holder may manage a small team but this will not always be the case
- Evaluates the plans of correction submitted from health care facilities and conducts follow up visits to determine ongoing compliance with rules and regulations for certification and licensure
- Minimum 2 years of clinical patient care experience required
Qualifications for health care specialist
- Work with the incomplete log and sent denial letter if require
- Participate in special projects as necessitated by business needs
- Five (5) years’ minimum experience in project work (including building and managing project plans), monitoring outcomes and trends and the processes supporting the release of the data
- Three (3) years’ experience with Medicaid, Social Security Administration (SSA), other health data specific to state and federal policies and procedures
- Must be able to analyze data and situations
- Bachelor’s Degree in Computer Technology or related field is preferred, or in lieu of degree, an equivalent of 4 additional years of experience in Computer Technology or related field is required
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Health Care Specialist Job Description
Job Description Example
Our innovative and growing company is looking for a health care specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for health care specialist
- Responsible for phone calls/interviews with patient, family member and/or physician offices
- Respond to prospective new student inquires via outbound phone calls
- Discuss prospective student’s background, goals and objectives to determine fit with GCU’s academic programs
- Forward qualified student inquiries to enrollment counselor depending on area of interest
- Demonstrate effective interpersonal skills during all transactions
- Serve as an active member of a graduation team focused on student success and retention
- On site resource that will act as an extension of the call center
- In depth understanding of the client’s hub services and offerings
- Champions the client’s team approach to supporting their customers
- Solicits real time feedback from the client’s customers
Qualifications for health care specialist
- 1+ years of experience with SQL (or similar tool) for developing and maintaining business intelligence and analytic reports or similar products used to perform business intelligence reporting from a central database
- 1+ years of experience with Business Objects (or similar tool) for developing and maintaining business intelligence and analytic reports or similar products used to perform business intelligence reporting from a central database
- Certified nurse practitioner through ANCC / AANP for adult, acute care, family and/or geriatrics required or physician assistant with certification
- Post-grad hands-on clinical experience
- At least two years college education or an Associate Degree
- Computer system knowledge like CCMS platform)
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Health Care Specialist Job Description
Job Description Example
Our growing company is looking for a health care specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for health care specialist
- Educating physician office staff on the use of our client’s patient assistance and call center support services, including web based provider program
- Providing expertise or general support in reviewing, researching, investigating, negotiating and resolving all types of complaints / grievances
- Evaluate the financial aspects of product development, such as A&P budgets, expenditures, research and development appropriations, return-on-investment & profit-loss projections
- Concurrently and retrospectively, collects data from patient electronic health records and variety of computer generated sources, on all admitted trauma and burn patients
- Gather accurate information to process records and determine eligibility into the trauma or burn registry using inclusion criteria
- Encodes the data, including ICD-10 coding, trauma registry coding, abbreviated injury scoring and injury severity scoring, using pre-established guidelines
- Participates in the development of evaluation methods of health care services and related programs in order to determine the degree of acceptance and utilization of health care, type and breadth of service, characteristics of recipients, extent of involvement of professional workers, operational costs and other related activities
- The Product Specialist – Health Care is focused on supporting the top 80% of the disciplines within their portfolio (based on sales) by providing Product/Digital information and support for all sales channels
- The Product Specialist – Health Care will support sales requests for help at the direction of the marketing team, creating customized sales tool for Top Targets, doing product mapping, running virtual demos of digital for prospective customers, helping in convention coverage, and other product knowledge-dependent activities for closing sales
- The Product Specialist – Health Care is expected to have or develop an expert level of knowledge and understanding of product pedagogy, digital strategy, functionality, and future direction so that they can effectively support sales activities
Qualifications for health care specialist
- Master's degree in healthcare, information systems, computer science, engineering or related fields OR six (6) years of experience in a directly related field
- Ability to conduct brief, evidence-based and developmentally appropriate screening
- Minimum of 5-7 years' experience in pharmaceutical and/or health care/sales including experience with the different account customer types
- Hospital experience and/or contract negotiation
- Ability to understand account specific needs and identify resources and opportunities to partner around those needs
- Ability to work well with and influence peers and management