Care and Outreach Specialist - PHP - Telephonic - Temporary

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

The Care and Outreach 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 connection to community resources for the organization’s most vulnerable, at-risk members.

The Care and Outreach Specialist is responsible for member outreach and follow-up related to various organizational initiatives. This role will help identify and support unmet member needs identified through proactive outreach 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 Target

Bonus - SIP Target, 5% Annual

Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.

Essential Responsibilities

Receive completed health risk assessment and/or screening information and review all available and relevant member information to identify unmet physical, behavioral, social, cognitive, or medical needs.
Proactive member outreach 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 handoff of members with complex 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 all related activities.
Provide cross-training on specific job responsibilities.

Maintain compliance with all 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 continuous 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

Minimum 3 years of directly related 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

Work directly or telephonically with a population similar to that found 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

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 Microsoft 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

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 all HIPAA rules
Ability to maintain professional boundaries and effective working relationships with internal and community service staff, members, and providers
Ability to develop 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 complex 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-related continuing education when 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 perform 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, reach, and climb stairs for at least 1-3 hours/day

Working Conditions

Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ 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 outside 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 competitive pay, 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. CareOregon 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

CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known 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.

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