Complex Care Resources Specialist

Posted 9 days ago

neighborhood healthcarePoway (CA)

Community Health Workers All Other Outpatient Care Centers

SENIORITY

Senior

SALARY

$22.88 - $32.08 per hour

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About the role

Neighborhood Healthcare Complex Care Resource Specialist 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. Role Overview and Purpose 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.

Responsibilities:

Completes thorough referral processes according to standard procedures and protocol to ensure accuracy
Tracks all referrals in the designated logs and via eCWDocuments 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

Education/Experience High school diploma/GEDValid 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

Additional Qualifications:

(Knowledge, Skills, and Abilities)
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

Physical Requirements:

Ability to lift/carry 25 lbs./weight
Ability to stand for extended periods of time
Compliance (Safety & HIPPA)
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 $32.08 per hour, depending on experience, education and additional qualifications. Compensation Disclosure: 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.

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