Complex Care Resources Specialist

Neighborhood Healthcare-posted 10 days ago

$23 - $32/Yr

Full-time • Entry Level

Poway, CA

501-1,000 employees

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

One year health-related field experience preferred
Bilingual (English/Spanish) or (English/Arabic) preferred

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

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