Job Description

Job Description

Job Description

Description:

Title: Referral Case Specialist

Base Salary Range: $45,760 - $47,840 plus benefits

FTE : Full-time, Non-Exempt

Seeking a skilled and dedicated Referral Case Specialist who wants to make a difference in our community. We want to hear from you if you thrive in a fast-paced, caring, and compassionate environment!

Our Mission: The Mission of South Central Family Health Center is to improve the quality of life for the diverse Community of inner city Los Angeles by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. To lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services.

General Summary: Under the direct supervision of the Referral & Medical Administrator, Referrals Case Specialist is responsible for coordinating interdepartmental patient referrals, processing referrals on the EMR and population software applications to ensure compliance with federal, state, or Health Plan specific requirements. Responsible for collecting data regarding quality measures and preparing reports for internal and external reporting purposes. The ideal candidate will have to perform some of the following essential duties.

• Provide day-to-day care coordination activities and referral follow-up from various medical departments, such as Women’s Health (OB), pediatrics, behavioral health, and dental, among others.
• Process and track all department referrals on a daily basis on NextGen EHR and patient population software
• Follow up on internal dental referrals and close completed referrals
• Schedule patients and manage patient referrals for dental specialty programs in conjunction with UCLA CBCE programs: Endodontics, Oral Surgery, and Pediatric Dentistry, as applicable
• Financial screening of patients, insurance, or other medical coverage verification.
• Assists in opening/closing the clinic
• Follows up on all specialists’ reports for medical providers
• Conducts culturally appropriate Multi-Component Care Plans and update as needed on a quarterly basis
• Assists the Referral Medical Manager with administrative duties on programs as it applies to Medi-Cal Managed Care, Healthy Families, and CPSP.
• Maintains close working relationships with case managers, social services, and admitting staff to successfully coordinate available services
• Responsible for ensuring the integrity and quality of Women’s health services delivered in the Comprehensive Perinatal Services Program (CPSP), Family Planning, OB/GYN, and other referral-related services.
• Provide referrals to WIC, dental, counseling services, family planning, and/or other community resources based on patient needs.
• Collaborate with other departments (Behavioral Health, Pediatrics, Dental and Primary Care) to connect patient to other services as part of their care.
• Utilize i2i tracks' perinatal tracking to collect and document all UDS prenatal data and keep data up to date throughout the pregnancy and postpartum.
• Received mental health referrals on i2i and close completed referrals on Nextgen.
• Mail out letters (follow-up letters, referrals, and re-engagement)
• Manage and coordinate client appointments efficiently, utilizing organizational systems and communication channels to ensure timely access to behavioral health services.
• Send test actions to medical providers to inform them about the patient’s mental health services.
• Provide education and information to patients and their families, paying particular attention to providing education in a manner most suitable for an effective client learning experience.

Qualifications and Experience:

• High School Diploma or equivalent required
• AA/AS Degree preferred
• Completion of formal health education program is required, preferably at Associate of Science level.
• Bilingual/ bi-literate English/Spanish required
• Must have a minimum of two (2) to three (3) years’ experience in a clinical setting
• Knowledge of health education issues as they pertain to family planning, the prevention of STD’s, appropriate self-care, and other psycho–social issues surrounding chronic diseases such as diabetes and hypertension.

Skills and Abilities:

• Good written, oral, and customer service skills
• Excellent interpersonal, organizational, and project management skills
• Proficient in MS Office Suite, Word, Excel, type 40 wpm
• Ability to handle multiple phone lines
• Multi-task and detail-oriented
• Ability to work well in a team environment, remains motivated, is self-directed, and demonstrates initiative.

Licensure and Certifications:

• Current California Driver’s License and Automobile Insurance

Top benefits or perks: As a team member at South Central Family Health Center, you’ll enjoy competitive wages and generous benefits:

• Benefits: Health care, dental, life insurance
• 403 (b) Retirement plan
• Education Reimbursement
• Career development: Entry-level employees have opportunities to work in management, HR, or other areas of the company.

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