Care Coordination & Complex Referrals Specialist

Neighborhood Healthcare; Poway (CA); On-site; USD 32,000 - 44,000; Full time

Benefits offered by this job

Medical benefits

Vacation time

Holidays including floating holidays

Sick/Personal time

Volunteer Time Off (VTO)

403b Retirement plan

Job summary

Neighborhood Healthcare seeks a Complex Care Resource Specialist to track and coordinate patient referrals across chronic care and social determinants of health (SDoH). Travel to various sites is required to train staff and attend meetings.

The role requires a valid CA driver’s license, a high school diploma, and healthcare experience; bilingual abilities are preferred. This position offers comprehensive benefits and growth opportunities within a private nonprofit health system.

Qualifications

• Excellent verbal and written communication skills.
• Knowledge of medical terminology and basic computer skills including spreadsheets and databases.
• Ability to manage multiple tasks and stay organized.
• Ability to work in a team and independently.

Responsibilities

• 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 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, coordinating 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

Skills

Communication skills

Medical terminology

Data entry

Teamwork

HIPAA compliance

Education

High school diploma/GED

Driver’s license and car insurance

1 year health-related field experience

Bilingual English/Spanish or English/Arabic

Job description

Neighborhood Healthcare seeks a Complex Care Resource Specialist to track and coordinate patient referrals across chronic care and social determinants of health (SDoH). Travel to various sites is required to train staff and attend meetings.

The role requires a valid CA driver’s license, a high school diploma, and healthcare experience; bilingual abilities are preferred. This position offers comprehensive benefits and growth opportunities within a private nonprofit health system.