Complex Care Resources Specialist

Complex Care Resources Specialist

Job Category: Admin - Non Medical

Full-Time

On-site

Poway, CA 92064, USA

Description

Community health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 96k people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance. We have been doing this since 1969, and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.

The Complex Care Resource Specialist works to support the mission and vision of Neighborhood Healthcare by tracking and coordinating patient referrals. The primary responsibilities are coordinating all chronic care and social determinants of health (SDoH) patient referrals and follow-up care for the patients. This position will require travel to NHC sites to attend designated meetings and train selected staff members.

Completes thorough referral processes according to standard procedures and protocol to ensure accuracy

Tracks all referrals in the designated logs and via eCW

Documents all actions taken in patient medical records in accordance with current Clinic, DHS, and health plan regulations/guidelines

Discusses all aspects of the referral process provided by the treating provider with patients, including the cost of referral under provider direction

Verifies insurance eligibilities and submission of treatment authorizations

Administers the SDoH program according to standard procedures and protocols

Collaborates and build partnerships with external entities to become familiar with referral sources

Maintains accurate lists of specialists/providers by funding source and other community resources as approved by the management

Acts as liaison between patients, clinic/providers, specialty care providers, health plans/funding sources, and community resources

Impacts patient experiences by demonstrating courteous and helpful behavior and a commitment to accuracy

Shares accountability for overall patient health outcomes, working in coordination with care teams

Operates to instill confidence in our care and in our facilities to patients, fellow employees, and other stakeholders

Attends meetings on and off site when deemed necessary by supervisor

High school diploma/GED

Valid California Driver's license and proof of car insurance required to travel to NHC site for trainings and meetings

One year health-related field experience preferred

Bilingual (English/Spanish) or (English/Arabic) preferred

Excellent verbal and written communication skills, including superior composition, typing, and proofreading skills

Ability to interpret a variety of instructions in written, oral, diagram, or schedule form

Knowledgeable about and experience with medical terminology, computer skills, including familiarity with spreadsheets and databases required

Ability to successfully manage multiple tasks simultaneously

Excellent planning and organizational ability

Ability to work as part of a team as well as independently

Ability to work with highly confidential information in a professional and ethical manner

Ability to lift/carry 25 lbs./weight

Ability to stand for extended periods of time

Follow all safety procedures as outlined in Neighborhood Healthcare's Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately

Maintain current knowledge of policies and procedures as they relate to safe work practices

Follow all safety procedures and report unsafe conditions

Use appropriate body mechanics to ensure an injury free environment

Be familiar with location of nearest fire extinguisher and emergency exits

Follow all infection control procedures including blood-borne pathogen protocols

Maintain privacy of all patients, employee and volunteer information and access such information only on a need-to-know basis for business purposes

Comply with all regulations regarding corporate integrity and security obligations

Report all behavior and/or activity that are unethical, fraudulent, or unlawful

Neighborhood Healthcare offers a generous benefit plan that includes: Partially company paid Medical, Dental, and Vision Plans. Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more!

Pay range: $ 22.88 to $32.04 per hour, depending on experience, education and additional qualifications.

The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate's overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.