Program Coordinator - Advanced Illness Care (24323)

Job Title

Program Coordinator

• Advanced Illness Care

Department

HCP Advanced Illness

Exemption Status

Non-Exempt

Requisition #

24323

Direct Reports

n/a

Manager Title

Director

• Advanced Illness Care

Pay & Benefits

Estimated hiring range $ 24.54 - $29.70 / hour, 5% bonus target, full benefits.

www.careoregon.org/about-us/careers/benefits

Posting Notes

This a 0.2FTE hybrid role with 1-2 days per week or month in the Community or Office.

Job Summary

This position is the primary point of contact for the Advanced Illness Care Program (AIC) with responsibility of receiving and processing new patient referrals, as well as technical and data management. This position works with our referral sources (patients, family, case managers, facilities, clinics, etc.) and manager to screen and triage potential new patients and assign new and established patients to clinicians. This position is also responsible for program data tracking in Electronic Health Record (EHR) and reporting for payers and organizational leadership. This position provides billing support and review of unpaid claims. This position additionally provides administrative support to the department.

Essential Responsibilities

Intake Support

• Administers all aspects of the patient intake process by receiving and processing all incoming referrals.

• Collaborates with clinicians and/or supervisor to gather necessary information to determine appropriateness for services.

• Communicates with referral sources if patient is not accepted for services and provides information about alternative community programs and resources.

• Receives all incoming calls regarding program and provides instructions on referral process to AIC, hospice and primary care programs.

• Serves as the initial contact for patients, provides support and transfers to appropriate team member, as needed.

• Provides weekly updates/reporting to Collective Platform.

• Completes patient chart set up in EHR and requests and adds records needed to process referral. Ensures accuracy, completeness and compliance with regulations, certification standards, legal and ethical standards according to policies and procedures.

• Updates EHR database, including entry of new physicians, organizations, billing and service codes, as needed.

Billing and Clinical Support

• Provides support to billing team to ensure payment of claims and prepare monthly billing charts.

• Establishes and maintains provider portals and performs initial insurance verification with subsequent monthly eligibility checks maintaining all records, which may include, knowledge of program eligibility requirements for multiple payers.

• Enters and reviews documentation in the electronic medical records, assuring accuracy, completeness and compliance with regulations, certification standards, legal and ethical standards

according to policies and procedures.

• Provides first point of support for EHR and Collective Platform.

Quality Improvement Support

• Generates reports for leadership.

• Disseminates information to the clinical team about significant updates.

• Monitors and reports transition in care support.

• Monitors and maintains knowledge of quality and compliance requirements.

• Performs data collection, synthesizing and reporting required for payers and other programs.

• Contributes to workflows to improve team understanding, partnership and engagement with quality measures.

• Learns and assists in reviewing data and identifying trends.

• Prepares for and participates in payer quality audits.

• Tracks Medicaid redetermination dates and monitors patients for Medicare age-in dates and provides notifications to team.

• Responsible for smooth transition of patients into other Housecall Providers programs interacting with internal and external care teams as needed.

• Tracks reporting data and information to help inform and evaluate program, departmental, organizational metrics.

• Coordinates or participates in departmental projects.

• Works closely with CareOregon staff, primarily Population Health, to facilitate workflows and process improvements, when needed.

Essential Department and Organizational Functions

• Propose and implement process improvements.

• Meet deadlines for completion of workload.

• Maintain agreed upon work schedule.

• Demonstrate cooperation and teamwork.

• Provide cross-training on specific job responsibilities.

• Meet identified business goals that contribute to departmental goals.

• Maintain patient/family and staff confidentiality in compliance with HIPAA laws

• Participate in the coordination of the patient's care in accordance with professional standards of practice.

• Develop and maintain professional boundaries with all patients/family/caregivers.

• Serve as an ambassador for CareOregon and Housecall Providers at all times.

• Participate in orientation of new employees or volunteers when requested.

• Attend staff and mandatory in-services meetings, as required.

• Participates in performance improvement efforts to continually assess and improve quality of care, as requested.

• Perform other duties as needed.

Knowledge, Skills and Abilities Required

• Knowledge of medical terminology, basic patient care, and palliative care philosophy

• Knowledge and use of Trauma-Informed language and principles

• Knowledge of Federal, State and Local regulations, and HIPAA privacy rules and regulations

• Advanced computer and Microsoft Office skills with the ability to organize, track, and report data

• Detailed understanding of electronic medical record systems and the ability to integrate updates to those workflows on a regular basis

• Knowledge of quality improvement concepts, roles, processes, and reporting and HIPAA privacy rules and regulations

• Excellent communication, organizational and time management skills; including taking comprehensive notes and synthesizing information in a manner that captures key questions; feedback; decision points; and action steps

• High degree of professionalism and customer service

• Willingness to seek support from clinical staff and/or supervisors with questions or in the event of complex situations

• Familiar and comfortable with a person-centered approach to communication, education and care planning

• Ability to perform administrative tasks and intake in a healthcare setting

• Ability to work independently and collaboratively in a fast-paced, evolving, multi-faceted environment by being flexible and adaptable

• Ability to work under pressure to meet deadlines and work flexible hours if needed

• Ability to plan, prioritize and coordinate multiple projects or tasks

• Ability to establish and maintain effective working relationships with diverse patients, staff, peer groups, and varied agency representatives

• Ability to adhere to organizational standards, policies and procedures

Physical Skills and Abilities

Lifting/Carrying up to 0 Pounds

Pushing/Pulling up to 0 Pounds

Pinching/Retrieving Small Objects

Crouching/Crawling

Reaching

Climbing Stairs

Repetitive Finger/Wrist/Elbow/

Shoulder/Neck Movement

1-3 hours/day

0 hours/day

1-3 hours/day

0 hours/day

0 hours/day

0 hours/day

More than 6 hours/day

Standing

Walking

Sitting

Bending

Seeing

Reading

Hearing

Speaking Clearly

0 hours/day

0 hours/day

0 hours/day

1-3 hours/day

More than 6 hours/day

More than 6 hours/day

More than 6 hours/day

More than 6 hours/day

Position may occasionally work longer than 8 hours/day.

Cognitive and Other Skills and Abilities

Ability to focus on and comprehend information, learn new skills and abilities, assess a situation and seek or determine appropriate resolution, accept managerial direction and feedback, and tolerate and manage stress.

The following cognitive or mental requirements are necessary on a daily basis:

• Critical thinking and clear verbal articulation

• Reading, writing, mathematics

• Drawing conclusions from written or computer-generated materials

• Implementing recommendations by coordinating people and/or other resources

• Developing plans, procedures, goals, strategies or processes

• Ability to manage conflict situations

• Ability to tolerate and manage stress and grief

Education and/or Experience

Required:

• Minimum 3 years' experience within medical services, health care, social services or related area, including exposure to medical terminology and records

• Minimum 2 years' experience in quality or care coordination support

• Minimum 2 years' customer service experience

Preferred:

• 4 years' experience or a 2-year certificate in medical services, health care, social services, or related area

• Experience with Medicaid and Medicare health plans and eligibility

• Experience working within a Medicaid and Medicare managed care environment and/or working with vulnerable populations in community medical or mental health settings

Working Conditions

• Environment: This position's primary responsibilities typically take place in the following environment(s) (check all that apply on a regular basis):

☒ Inside/office ☐ Clinics/health facilities ☐ Member homes

☐ Other_________________________________________

• Travel: This position may include occasional required or optional travel outside of the workplace, in which the employee's personal vehicle, local transit, or other means of transportation may be used.

• Equipment: General office equipment

• Hazards: n/a

#LI-Hybrid

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.