Job Description

POSITION SUMMARY:  The Outreach and Referral Coordinator will be responsible for the following: a) contractual outreach requirements and/or outreach to special populations defined through CCHA’s KPI initiatives; b) completing intake assessments supporting proactive identification of member needs; c) leading referral activities for engaged members, to include creating care coordination cases and assigning to appropriate care coordination program and level of care; and d) liaising between members and their primary care and/or behavioral health providers for streamlined care coordination, appointment scheduling, follow up, and member advocacy.

COMPETENCIES/ROLE-SPECIFIC FUNCTIONS:  

COMMUNICATION 

Communicates well both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and ideas with others, has good listening skills.

• Provides feedback and recommendations to leadership regarding Outreach and Referral Coordinator duties and functions 
• Promotes communication among team to identify and streamline roles and responsibilities
• Participates in meetings and presents information as needed
• Effectively communicates both verbally and written with clients, members, and care coordination team 
• Reliably consumes instructions from leadership and asks clarifying questions
• Reports on outcomes related to Outreach and Referral Coordinator initiatives
• Communicates professionally with providers, physicians, and other healthcare professionals

PROBLEM SOLVING

Breaks down problems into smaller components, understands underlying issues, can simplify and process complex issues, understands the difference between critical details and unimportant facts.

• Accurately coordinates referrals to other team members by: a) assessing for level of urgency and level of risk; b) reviewing, documenting, and determining appropriate level of care; and c) creating appropriate case requests 
• Implements appropriate intervention(s) in a timely manner to assure problem prevention and resolution
• Identifies, develops, and utilizes community resources appropriately
• Uses motivational interviewing to achieve desired outcomes for the member
• Effectively navigates systems in order to obtain information needed for specialized projects

PRODUCTIVITY

Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time well, handles information flow.

• Completes daily and monthly outreach requirements
• Accurately follows referral procedures
• Is able to prioritize multiple referrals and concurrent outreach requirements
• May involve project work, to include compiling special period reports and composing non-routine correspondence

SELF DEVELOPMENT

Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills, keeps knowledge and skills up-to-date, turns mistakes into learning opportunities.

• Takes initiative to obtain training that will improve proficiency
• Collaborates with care coordination team to learn how they manage caseloads and to support prioritization of work
• Receives constructive feedback from leadership team and puts into action

CUSTOMER FOCUS

Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met, solicits opinions and ideas from customers, responds to customers.

• Supports member engagement activities and is skilled at enrolling Medicaid members into care coordination programs
• Supports CCHA members, CCHA leadership, and CCHA care coordination team by operationalizing care coordination activities 
• Develops strong relationships with members to include handling escalated members and/or members with high acuity and high intensity needs
• Advocates on behalf of members with providers, specialists and community agencies

JOB KNOWLEDGE

Understands duties and responsibilities, has necessary job knowledge, has necessary technical skills, understands company mission/values, keeps job knowledge current, is in command of critical issues.

• Acts as the subject matter expert for Outreach and Referral Coordinator initiatives to assure best practices in outreach, engagement and communication 
• Has working knowledge of local community programs, government and social agencies, and conveys that knowledge to team members when appropriate
• Understands and effectively utilizes “specialized” resources
• Understands integrated care coordination program requirements 
• Maintains confidentiality and ensures compliance with HIPAA regulations
• Other duties as assigned

QUALIFICATIONS (EDUCATION/EXPERIENCE/KNOWLEDGE/SKILLS/ABILITIES):  

• High school diploma or GED, Certified MA preferred.
• One year data entry; creating and maintaining documents and records.  
• One to Two years in healthcare setting preferred.
• Available to begin workday as early as 8 am.
• Advanced computer skills utilizing Microsoft Excel, Word and Outlook.
• Customer service skills.
• Adaptable to change on a regular basis.
• Excellent customer service skills and ability to effectively interact with PHP personnel, medical and facility staff, managed care organizations and the general public.
• Precise and detail oriented in managing, editing and communicating census data through spreadsheets and computer systems.
• Ability to work effectively and communicate with other teams and personnel within the PHP organization.
• Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures.

This position is eligible for medical, dental and vision insurance, paid time off (PTO), paid holidays, company paid life insurance, a 401(k) with matching, and tuition reimbursement._ _

PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear.  The employee is frequently required to stand; walk; reach with hands and arms and stoop, kneel, crouch, or crawl.  The employee is occasionally required to climb or balance. The employee must regularly lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision and ability to adjust focus.  

WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  The noise level in the work environment is usually moderate.