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EPSDT Coordinator - Honolulu, HI

UnitedHealth Group

Honolulu, HI
Job Code:
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Job Details

EPSDT Coordinator - Honolulu, HI(Job Number:724761)

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)
Positions in this function are responsible for supporting prevention interventions, coordination, data collection, and measurement of EPSDT services. This position is responsible for ongoing improvement activities associated with EPSDT eligible members, and reports to the Quality Management Leader or manager. In addition, the EPSDT Coordinator reviews, identifies, and works with management to resolve any problematic EPSDT issues.
Primary Responsibilities:
  • Phone calls and / or letters to providers to discuss issues and concerns
  • In-person visits with member and or personal representative to review and address concerns and issues (including compliance issues)
  • Training to providers, community organizations and other identified groups to improve understanding of our EPSDT program, changes to the program and provision of information regarding community resources
  • On-site training visits to the providers when requested
  • Assist the health plan in meeting EPSDT quality requirements
  • Design and manage specific Quality Improvement (QI) interventions related to ensuring member receipt of EPSDT services and the creation of health improvement strategies under the direction of the QM Leader or manager
  • Assist with monitoring of EPSDT data entry efforts and support monitoring and execution of follow-up, coordination of care and referral activities based upon EPSDT data obtained from EPSDT forms
  • Support health plan coordination actions associated with State of Hawaii Department of Health Early Intervention Section (EIS) efforts to offer support and services for children with developmental delays or disabilities
  • Support and monitor health plan responsibilities associated with the Vaccines for Children (VFC) program
  • Develop provider and member education and training materials related to health promotion
  • Meet with medical providers to discuss EPSDT, EIS or VFC activities, requirements or performance
  • Create and review reports for submission to health plan leadership or regulators
  • Summarize data or other information using Excel, MS Access or other data manipulation software
  • Become a subject matter expert on EPSDT and EIS activities and serve in this capacity for the health plan
  • Strong problem solving skills and the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
  • Strong organizational skills and ability to work both independently and in teams with attention to detail
  • Make formal presentations in front of committees or work groups
  • Participate in cross-functional meetings and serve as a liaison for regulators or other community-based organizations
  • Work independently on assigned projects under the supervision of the QM Leader or Manager
  • Ensuring that key health plan staff (Service Coordination Team, Member Services and Provider Service Representatives) is aware of state and federal EPSDT requirements are an important part of the EPSDT Coordinators educational responsibilities
  • The EPSDT Coordinator conducts trainings and answers questions for key health plan staff on EPSDT requirements and ensures understanding of state and federal EPSDT requirements. Educational and other information is shared through in-services, update notices and emails
  • Conduct an annual evaluation of the processes and outcomes for EPSDT program and continuous quality improvement activities

Job Clinical Quality Management
Primary Location US-HI-Honolulu
Other Location 
Organization C&S Quality Management
Schedule Full-time
Number of Openings 1
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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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