Referral and Care Coordination Specialist (Temporary)

Job Description

Job Description

About BHT  

Better Health Together (BHT) has been leveraging experience, knowledge, and resources to coordinate action and address local and regional health inequities across Ferry, Stevens, Pend Oreille, Spokane, Lincoln and Adams counties and the Reservations of the Kalispel Tribe of Indians, the Spokane Tribe of Indians, and the Confederated Tribes of the Colville reservation since 2014.  

About the Community Care Hub  

BHT is now working across health care and social service delivery systems as a  Community Care Hub (CCH) so that all members of our community have access to the resources they need to thrive. We were founded on the principle that when we step back and let the local community lead, we find the most equitable and sustainable solutions to some of our most complex problems.   

About the Position 

The Referral and Care Coordination Specialist is a temporary position through July 31, 2027 to support client care and referral efforts for the Community Care Hub. Responsibilities include:

• Sixty Percent of this position will be the delivery of basic needs support services to families and/or individuals who are child welfare-involved and experiencing material hardship in Spokane. This includes resource navigation services, distribution of practical, everyday items to clients,
  and financial documentation (receipts, invoice processing, filing, etc). 

• Forty Percent of this position will be supporting patient and community member outcomes through referrals into the Community Care Hub, which may include health eligibility screenings and referrals. Case assignments may vary in location (including rural areas within the BHT region of Adams, Ferry, Lincoln, Pend Orielle, Spokane, Stevens, and the Tribal reservations of the Colville Confederated Tribes, Spokane Tribe of Indians, Kalispel Tribe of Indians). Mileage reimbursement is included in employment.  

 
Essential Job Functions 

Impactful Problem Solver + Highly Organized  

• Conduct outreach and patient-centered support & referrals in hospitals, clinics, rural communities, and community-based settings. 

• Support warm handoffs to care coordination by collaborating with interdisciplinary teams (providers, nurses, case managers, social workers) on an as-needed basis;  

• Deliver culturally responsive and community informed information to partners, providers, nurses, case managers, social workers, community-based workers, and other relevant stakeholders; 

• Adapt to varying workflows, care teams, and environments, including independent work in rural and community-based settings; 

• Maintain confidentiality and comply with HIPAA and Hub policies; 

• Be detail oriented supporting compliance requirements;  

• Have excellent digital file management skills; 

• Be proactive in organization and problem solving; 

• Demonstrate initiative to complete tasks - assigned or relates to their program(s); 

• Ensure referrals are timely, accurate, and complete in the client management system. 

Effective Coordination + Communicator 

The CBW position requires developing and maintaining key relationships with internal and external partners to ensure program satisfaction.  

• Strong interpersonal skills with the ability to build trust across diverse populations, including rural communities; 

• Excellent communication skills, with the ability to translate health information into understandable terms; 

• Ability to navigate both formal healthcare systems and informal community networks 

• Strong organizational and time management skills, especially in a flexible, ad hoc work structure; 

• Critical thinking and problem-solving skills, particularly in low-resource or geographically isolated settings; 

• Ability to work independently in rural or field-based environments as well as collaboratively within teams; 

• Reliability and strong follow-through in short-term or intermittent assignments; 

• Highly competent and confident with technology, including being a point-of-contact for tech questions for their team and has high comfort using new technology; 

• Experience with handling/managing and reviewing sensitive documents, including Personal Health Information (PHI);  

• “Super User” skill level for CCH Client Management System and other Client Management systems for program/project coordination (these systems can be trained for) 
  

Equity and Inclusion Champion 

The Community Based Worker understands the importance of how resources, programming, and partnerships can disrupt systemic racism and oppression. The Community Based Worker centers the needs of impacted communities when executing their job functions and makes decisions for their program(s), in alignment with BHT’s mission and values. Additionally:    

• Demonstrates an ambitious desire to improve equity health for all; 

• Demonstrates the initiative to learn and enhance skills that promote anti-racism, cultural responsiveness, and an understanding of systems of oppression and their impact on health outcomes; and 

• Participates in intentional learning efforts, including events relating to understanding and dismantling institutional racism and building cultural responsiveness. 

Qualifications 

• Experience with care coordination
• Preferred Certificate as a Community Health Worker or similar certification.

• Lived experience that fosters connection with the populations served. 

• Experience working in and familiarity with resources in rural or underserved communities. 
• Cultural humility and respect for diverse lived experiences and community contexts; Empathetic, compassionate, and nonjudgmental approach.
• Able to prioritize and multi-task in a fast-paced work environment; consistently delivering on established schedules, guidelines, protocols, and deadlines. 
• Proficiency in technology, including the client management system, and Microsoft Office tools, in a productive and efficient way.

Compensation

• $69,000-80,000
• Health Benefit premiums fully paid by BHT for you and your dependents (Medical, Dental, Vision, STD, Life)
• 401k Employer Contribution of 6% by BHT (no employee match required)
• 6 Weeks of PTO and Sick Leave