This position is responsible for meeting the following regulatory, contractual, or other requirements on behalf of PrimeWest Health:
1. Complete job duties in accordance with Minnesota Department of Human Services (DHS), Centers for Medicare & Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA) requirements
B. Role and Key Responsibilities Assist the Population Health Manager and PrimeWest Health staff in the following as needed:
1. Administration
a. Answer phones; process mail; and manage/schedule meetings, calendars, appointments, etc.
b. Perform data entry and update spreadsheets, disseminating information as directed
c. Perform other miscellaneous administrative duties including creating and organizing files, copying, faxing, scanning, and mailing as needed
d. Track member participation in PrimeWest Health’s in lieu of services (ILOS) diabetes meal program and Focused Wellness programs
2. Clinical/Professional
a. Complete follow-up phone calls as assigned for members with identified needs
b. Assist in administering PrimeWest Health’s Focused Wellness programs with a focus on the diabetes program
i. Open Focused Wellness cases, make appropriate documentation in the care management system, create letters and mail appropriate educational literature as indicated, enter returned Focused Wellness questionnaires in the care management system, and close cases as needed
ii. Complete Focused Wellness questionnaires over the phone for identified PrimeWest Health members
iii. Encourage identified members to participate in the program using motivational interviewing techniques and goal setting as appropriate for the member’s condition
iv. Fax members’ Focused Wellness program participation information to providers
v. Send thank-you letters and appropriate educational literature to members who have indicated they want to participate in Focused Wellness programs
vi. Collaborate with the home-delivered meals vendor as needed for the enrollment of identified members into the meals program and maintain communication with the meals vendor for the duration of program engagement
c. Assist in the development and implementation of population health management strategies and programs with a focus on the diabetes Focused Wellness program.
PrimeWest Health is an Equal Opportunity Employer Committed to Diversity, Equity, and Inclusion
Position Description: Population Health Specialist Page 2 of 2
i. Implement data-driven population health management strategies under the direction of the Population Health Manager and Chief Senior Medical Director
d. Participate in community health and wellness events
i. Represent the PrimeWest Health Care & Population Health Management department at community health and wellness events within the 24-county service area
3. Reports
a. Perform annual satisfaction surveys for Care & Population Health Management and Focused Wellness; record results in Excel
b. Review claims reports to identify trends in utilization
C. General PrimeWest Health Responsibilities
1. Abide by the PrimeWest Health Code of Conduct
2. Comply with all PrimeWest Health policies and procedures
3. Comply with the Health Insurance Portability and Accountability Act (HIPAA) and all other privacy laws
4. Be familiar with building safety procedures and alert maintenance if something requires attention
5. Keep public areas of the department and office neat and clean
6. Conduct other responsibilities and activities as needed and assigned
D. Professional Competencies – N/A
E. Educational Requirements and Required Qualifications
1. At minimum, Licensed Practical Nurse (LPN) diploma
2. Experience in diabetes management and health coaching preferred
3. Knowledge of, and proficiency in, Word, Excel, and Outlook required. Experience in relational databases and business information systems is a plus.
4. Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Good verbal and written communication skills.
5. Ability to sit at a desk or computer station most of the time. Ability to occasionally lift and/or carry such articles as file folders and small boxes up to 30 pounds.
6. Ability to travel approximately 20 percent of the time, including overnight travel.
F. Appropriate Licensure and Certification Requirements
1. Must possess current and unrestricted LPN license
2. Must attend continuing education sessions each year to support license requirement
G. Collaborative Efforts with Other Departments
1. Administrative Services
2. Business IT & Claims Administration
3. Corporate Compliance & Auditing
4. Information Systems & Technology
5. Member & Provider Services
6. Operations
7. Pharmacy Management
8. Quality & Utilization Management
H. Supervision – N/A

This position description is not to be construed as an exhaustive statement of essential functions or responsibilities.

Alexandria, Minnesota – This position offers the possibility for hybrid work.

PrimeWest Health will accept résumés for this position until filled. No phone inquiries please. Employment to begin as soon as possible.