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MCO Panel Assistant

Company: Mary's Center
Location: Silver Spring
Posted on: June 9, 2021

Job Description:

Mary's Center is committed to promoting diversity, equity and inclusion (DEI) within our organization and the communities we serve. We embrace diversity of experiences, ideas, and individuals, and seek to bring a diverse group of candidates to the table.

Provides case management/utilization review and outreach in order to engage a panel of patients. The overall goal of this position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review, navigation, relationship development and outreach. Ability to effectively identify patients' barrier(s) to care and provide community resources based on individualized needs in order to achieve positive patient outcomes. Complete a daily spreadsheet reflecting productivity. Produce and submit a weekly productivity spreadsheet report and patient tracking sheet reflecting outreach and numbers scheduled.


This position reports directly to the MCO Panel Nurse Manager.

Essential Duties & Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

  • Oversee and coordinate care for a panel of patients through outreach and engagement techniques.

  • Promote effective and efficient utilization of clinical resources.

  • Mobilizes resources, as needed, to engage patients in order to achieve expected clinical and quality outcomes within the desired timeframe.

  • Identifies and addresses barriers to care on an as needed basis.

  • Provide follow up and continued oversight to panel patients, addressing any concerns and/or issues that arise.

  • Coordinate and communicate with clinicians in order to facilitate patient's needs.

  • Work closely with the MCO Panel Nurse Manager and Managed Care Organizations (MCO) to determine urgency for patients who have chronic illness or other health needs.

  • Communicate at regular intervals with the appropriate Managed Care Organization (MCO).

  • Understand patient scheduling and referral process.

  • Evaluate patient satisfaction, financial considerations, and quality of care provided on an as needed basis.

  • Create, maintain, and disseminate data as required by Mary's Center and/or the Managed Care Organization (MCO).

  • Serve as a patient advocate. Enhance a collaborative relationship between Mary's Center and the MCO in order to maximize the ability to meet patient's and family's needs.

  • Monitor trends in patient utilization data. Responds in a collaborative way to alter trends to enhance effective and efficient utilization of clinical resources.

  • Learn effective use of MCO portals

  • Contact MCO representatives on a regular basis in order to promote communication and to follow up on projects.

  • Work on increasing HEDIS scores at Mary's Center

  • Ethics- Understand and respect the fact that workload varies; accept urgent and/or non-urgent projects as delegated by Supervisor

  • Interpersonal skills- Attempt to resolve issues in a positive manner.

  • Identify barriers and also identify possible solutions.

  • Schedule a minimum of 75 appointments weekly. Send a copy of daily appointments to Supervisor via email daily.

  • Employee may not arrive earlier than 8AM in order to leave early without prior authorization from supervisor, per Mary's Center and or/MCO Panel Dept. leave policy.

  • Make vacation time off requests through Paycom a minimum of two (2) weeks in advance. Please refer to Mary's Center call out policy for other requests.


The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience - Minimum of High School Diploma or GED Equivalent. Must possess a minimum of 1 (one) year of experience in direct patient care and/or medical assistant certification or registration. Experience working in community health settings with immigrant populations and/or maternal-child health preferred. Bilingual in English and Spanish and/or other languages a must. A thorough understanding and working knowledge of patient confidentiality issues and HIPAA compliance/regulations are essential.

Physical Demands - Regularly required to sit; frequently required to reach with hands and arms; required to walk, stoop, kneel, crouch, talk or hear; must be able to lift objects up to twenty-five (25) pounds

Work Environment - In a typical clinical office setting with quiet to moderate noise level and designate a home office space for remote work.

Keywords: Mary's Center, Silver Spring , MCO Panel Assistant, Other , Silver Spring, Maryland

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