Program Specialist - Care Coordinator

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke HomeCare & Hospice Pursue your passion for caring with Duke HomeCare & Hospice, which offers hospice, home health, and infusion services across the region, as well as serves as the home forthe Duke Caregiver Support Program. Team members work closely with a patient's physician to provide comprehensive, individualized care in the comfort of their home or at our inpatient hospice facility in Durham, NC. Work Arrangement - Onsite Duke Homecare & Hospice 12 Moore Drive, Suite 200 Durham, NC 27713 Monday – Friday 8 am -5 pm with holiday coverage Job Summary Perform a variety of specialized, complex activities in the coordination of care needed for patients. Strong emphasis on proactive problem resolution and departmental communications. Independently perform activities necessary to organize, maintain, and use electronic patient health records. This position will have high customer service, strong analytic and problem-solving skills. This position will also require interpretation and explanation of policy and external requirements related to privacy, release of information, positive patient identity, and other department and organization-wide functions. Regular interaction is required with clinic staff, case management/hospital staff, and community-based third-party organizations. Job Relations Coordinate Home Health, Hospice, and Home Infusion services in collaboration with Community Program Managers. Participates in daily Business Development Huddles. Closely monitors pending referrals and prioritizes task as assigned. Review and complete referral requests, daily. Work extensively in the electronic health record to locate specific clinical documents for the purpose of fulfilling a referral. Escalate more complex inquiries and barriers to the appropriate resource. Understand and verbalize the insurance verification process. Collaborate closely with the requesting Program Manager regarding barriers to completion of referral or other duties. Provide timely updates of referral completion and ensure appropriate documentation is complete. Maintain strong working relationships with both internal Duke staff as well as community-based third-party organizations and facility staff to ensure timely, appropriate, and safe transitions of care. Maintain proficiency in electronic medical record systems including but not limited to EPIC, CareTend, and CareLink. Participation including attendance to community health events. Coordination of meetings and execution of meeting notes when needed. Develop, administer activities, monitor and evaluate program effectiveness, and investigate trends. Advise Community Program Managers as to the status of current activities and additional or expanded program requirements. Provide input into appropriate program recommendations. Assist in developing and defining short and long term departmental specific goals and objectives. Implement decided upon program adjustment. Coordinate projects and audits to improve processes related to care coordination. Interpret and explain Duke HomeCare and Hospice service lines, to include Home Health, Hospice and Home Infusion, release of information, positive patient identity, and other department and organization-wide functions. Apply detailed working knowledge of HIPPA rules and other State and Federal laws regarding patient privacy and knowledge of Joint Commission requirements and CMS guidelines and rules. Perform other duties as assigned Minimum Qualifications Education Work requires analytical, communications and organizational skills OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE generally acquired through completion of a bachelor's degree program with one year of experience in program administration or event production. -OR- Two years of postsecondary education with three years of experience in program administration or event production. Preferred experience in healthcare, hospital, homecare and/or hospice. Experience Strongly preferred: Two years of experience in home care referral, discharge planning, or insurance verification This position primarily focuses on insurance verification, including reviewing out-of-network benefits and verifying insurance coverage in the patient chart. Patient interaction is minimal, approximately 10% of the role. Key responsibilities include supporting the team with established processes and procedures, ensuring accuracy of insurance information, and assisting with workflow coordination. A strong understanding of the differences between home health and hospice services is essential, as this knowledge is critical when reviewing coverage and navigating payer requirements. Candidates should be detail-oriented, process-driven, and comfortable working within complex insurance and healthcare systems. Knowledge, Skills, And Abilities Computer skills to include intermediate to advanced Microsoft Word and Excel experience Detail-oriented with strong customer service skills Willing to learn and take on other tasks Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. #J-18808-Ljbffr Duke University Health System