Career Opportunities: Referral and Access Coordinator - Behavioral Health (24663)

Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.

Job Summary

The Referral and Access Coordinator will provide direct support to the CareOregon Single Point of Contact (SPOC) to manage referrals and waitlists for specialty behavioral health programs and services outlined under CCO 2.0 as well other programs identified by CareOregon Behavioral Health and Population Health Partnerships leadership. This role will involve frequent and timely communication with referents, delivering providers, community behavioral health partner organizations, and internal CareOregon departments to identify available service capacity, address logistical barriers to access, notify SPOC of clinical barriers to access, and document outcomes of the referral process. Additionally, this position will help track referral and service placement data for the purposes of regulatory and process-improvement reporting. Lastly, this role will support SPOC with the coordination and documentation of recurring provider network and community partner meetings.

Essential Responsibilities

Referral & Waitlist Coordination

• Track referrals from the point of authorization, through the provider screening process, to the point that a member is either enrolled with the requested service, an alternative service, or the referral is withdrawn.
• Daily email, phone, and video conference communication with multiple referral stakeholders.
• Document all referral communication via the PHP electronic care management platform.
• Update electronic care management care plan with outcome of referral.
• Monitor notifications of changes in member health status to notify SPOC of need for clinical referral triage re-assessment.
• Monitor member placement on waitlist and notify stakeholders of service availability timeframes.
• Coordinate with CareOregon Behavioral Health Utilization Management and Prior Authorization Teams regarding updates to member authorizations.
• Communicate with community behavioral health clinical providers to gather, organize, and disseminate information about current treatment slot/referral capacity availability for youth and adult behavioral health higher levels of care on a regular cadence.
• Refer members into Regional Care Team Care Coordination or Intensive Care Coordination as needed.

Data Tracking & Reporting

• Run daily reports of new behavioral health service authorizations.
• Enter new referral coordination (SPOC) program enrollments into the PHP electronic care management platform.
• Gather behavioral health provider service capacity data on a recurring schedule.
• Generate monthly reporting of referral volume, waitlist volume, and service access timeframes.
• Collaborate with SPOC and PHP Triage & Data Management teams to refine program reporting.

Meeting Coordination & Documentation

• Assist with preparing agendas for recurring provider network meetings by consulting with SPOC and PHP leadership.
• Send scheduling and agenda communication.
• Document and disseminate meeting minutes.

Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Meets MHACBO criteria for QMHA certification
• Minimum 3 years of direct experience with system navigation and resource coordination with behavioral health staff from different settings including acute inpatient care, sub-acute, outpatient, residential facilities, and Community Mental Health Program (CMHP/county) behavioral health programs

Preferred

• QMHA-I or II certification
• Experience working with specialty behavioral health services such as Assertive Community Treatment (ACT), Intensive Case Management (ICM), Home-Based Stabilization (HBS – youth), psychiatric sub-acute, respite, or residential treatment

Knowledge, Skills and Abilities Required

Knowledge

• Knowledge of Oregon Administrative Rules (OARs) pertaining to behavioral health services
• Familiarity with Oregon Civil and Forensic Commitment systems
• Familiarity with behavioral health utilization management concepts and behavioral health levels of care
• Understanding of the nature of member engagement and vulnerable, at-risk populations
• Applied knowledge of the social determinants of behavioral health and the unique needs of low-income and marginalized communities
• Awareness of the behavioral health system strategies to engage and improve behavioral health outcomes in this population
• Understanding of the impacts of trauma on behavioral health
• Intermediate understanding of behavioral health clinical terminology and general familiarity with common psychiatric 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, Collective electronic health record applications and other sources of clinical information or comfort and experience with learning new systems

Skills and Abilities

• Clear and collaborative written and verbal communication skills
• Excellent organizational skills and ability to manage multiple tasks with emphasis on referral coordination priorities
• Ability to synthesize multiple aspects of members’ behavioral health or social situations especially those pose a risk to member or community safety and/or may increase utilization of crisis services
• Ability to effectively gather relevant behavioral health and social information from community providers and health system partners
• Ability to develop a concise, initial assessment to appropriately triage and prioritize daily work- flow
• Willingness to seek support from clinical staff and/or supervisors in the event of complex situations
• Excellent interpersonal and customer service skills
• Ability to work independently in a fast-paced, multi-faceted environment and using sound judgment
• Strength in the areas of critical analysis, creative problem-solving skills, and collaboration in multi-disciplinary teams
• Proficiency with data entry and tracking tools
• Detail oriented; timely and accurate record keeping skills
• 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, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 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.

#LI-Remote

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.