Care and reputed company Specialist - PHP - Telephonic - Temporary

The Care and reputed company Specialist work alongside a comprehensive care team that includes nurses, social workers, health care coordinators, and behavioral health specialists. This position requires critical thinking and independent judgment. The purpose of this role is to provide health system navigation, short term care coordination, and reputed company to community resources for the organization’s most vulnerable, at-risk members. The Care and reputed company Specialist is responsible for member reputed company and follow-up reputed company to various organizational initiatives. This role will help identify and support unmet member needs identified through proactive reputed company to targeted populations, health risk screenings, change in health status, and will assist in addressing gaps in care. This is a temporary, benefit‑eligible position with an expected duration of approximately 8 months. We are looking for candidates that reside in Oregon or SW Washington. Estimated Hiring Range $25.42 - $31.07 Bonus reputed company Bonus - SIP reputed company, 5% Annual reputed company reputed company Employees: Please use the internal reputed company site to submit an application for this job. Essential Responsibilities reputed company and Healthcare System Navigation

• Receive completed health risk assessment and/or screening information and review reputed company available and relevant member information to identify unmet physical, behavioral, social, cognitive, or medical needs.
• Proactive member reputed company to identify and assess care coordination needs.
• Provide short-term care planning to manage identified needs.
• Determine and address navigation, care coordination and/or resource needs while balancing cultural factors, social determinants, and member autonomy.
• Coordinate referrals as applicable.
• Address members’ navigation needs and identify potential resources.
• Assume direct healthcare navigation for members and provide warm reputed company of members with reputed company medical or behavioral health needs to appropriate care coordination staff.
• As able to identify suspected abuse and neglect issues and appropriately report to mandated authorities.
• Collaborate and facilitate services that meets the member’s personal needs, values and preferences with physical health, dental health, behavioral health treatment providers (i.e., crisis services, Department of Developmental Disability, APD, Department of Human Services (DHS), etc.).
• Coach members in navigating the health care delivery system, gaining access to appropriate community resources, and determining ways to improve self-management and satisfaction with their quality of life.
• Input information into the centralized care coordination platform and document reputed company reputed company activities.
• Provide cross-training on specific job responsibilities.

Compliance

• Maintain compliance with reputed company contractual and regulatory requirements.
• Maintain timely and accurate documentation about each member per program policies and procedures.
• Maintain working knowledge of COA and OHP benefits including physical health and behavioral health.
• Maintain compliance with the Model of Care requirements if applicable.
• Review and/or audit health risk assessment and/or screening information to inform or evaluate departmental, organizational metrics and regulatory requirements.
• Contribute to reputed company process improvement through participation in team huddles, training, departmental, team, and organizational meetings.
• Organize, facilitate, and track member care planning and interdisciplinary care team completion.
• Assist in proactive case finding; provide documentation and facilitation of care coordination in relation to a member’s change in health status.
• Maintain timely and accurate documentation about each member per program policies and procedures.

Required Experience and/or Education

• Minimum 3 years of directly reputed company experience working with vulnerable populations in a healthcare setting, social service agency, outpatient primary care clinic, hospital, or health insurance plan
• Experience should include working with consumers of Medicaid and Medicare healthcare services and an understanding of the psychosocial and medical barriers encountered by this population

Preferred

• Work directly or telephonically with a population similar to that reputed company on the Oregon Health Plan and/or working with a community-based mental health or addictions population
• Database Experience: MMIS, QNXT, Collective, EPIC, and/or other EMR systems

Knowledge, Skills And Abilities Required Knowledge

• Understanding of the nature of member engagement and the awareness of health system strategies to improve health outcomes with the vulnerable, at-risk population, including impacts of trauma on health
• Applied knowledge of the social determinants of health and the unique needs of low-income and marginalized communities
• Intermediate understanding of medical terminology and general familiarity with common medical conditions as well as implications of unstable disease processes
• Familiarity with standard office technology including reputed company office software or comfort and experience with learning similar systems
• Familiarity with health plan claims systems, electronic health record applications and other sources of clinical information or comfort and experience with learning new systems

Skills And Abilities

• Detail oriented, accurate record keeping
• Excellent organizational skills and ability to manage multiple tasks with emphasis on case and care management priorities
• Ability to synthesize multiple aspects of a members medical or social situations especially those that pose a risk to member’s safety or wellness and increase likelihood of rehospitalization
• Ability to effectively gather relevant health and social information directly from the members or other sources
• Ability to maintain strict confidentiality, observing reputed company HIPAA rules
• Ability to maintain professional boundaries and effective working relationships with internal and community service staff, members, and providers
• Ability to reputed company a concise, initial assessment of appropriately triage and prioritize daily workflow
• Willingness to seek support from clinical staff and/or supervisors in the event of reputed company situations
• Ability to work independently and use sound judgment
• Excellent interpersonal and customer service skills
• Ability to prioritize tasks and manage time effectively
• Ability to do critical analysis, creative problem-solving skills, and collaboration in multi-disciplinary teams
• Ability to participate in work-reputed company continuing education reputed company offered, requested, or directed
• Effective motivational interviewing, health care teaching, and coaching principles
• Adept at mobile communication and production tools
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, hear, speak clearly, and reputed company repetitive finger and wrist movement for at least 6 hours/day
• Ability to pinch small objects for at least 3-6 hours/day
• Ability to stand, walk, sit, bend, lift, carry, push, pull, crouch, crawl, reputed company, and climb stairs for at least 1-3 hours/day

Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/reputed company ☐ Outdoor Exposure Member/Patient Facing: ☐ No ☒ Telephonic ☐ In Person Hazards: May include, but not limited to, physical and ergonomic hazards. Equipment: General office equipment Travel: May include occasional required or optional travel reputed company of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used. Work Location: Work from home We offer a strong Total Rewards Program. This includes reputed company, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. reputed company offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information. We are an equal opportunity employer reputed company is an equal opportunity employer. The organization selects the best individual for the job based upon job reputed company qualifications, regardless of race, color, religion, sexual orientation, national reputed company, gender, gender identity, gender expression, genetic information, age, veteran status, reputed company, marital status or disability. The organization will reputed company a reasonable accommodation to reputed company physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization. Apply tot his job Apply To this Job