CareOregon Looking for Referral and Access Coordinator – Behavioral Health at Portland, OR  Full Time

To protect the health and well-being of our members, employees and community, CareOregon requires all employees to be fully vaccinated against COVID-19 or have an approved medical or religious exception as a qualification of employment.

Candidates who receive an offer of employment by CareOregon, must provide proof of COVID-19 vaccination or submit a medical or religious exception request, which will be evaluated in accordance with CareOregon’s standard accommodation process.

Position Title: Referral and Access Coordinator – Behavioral Health

Department: Population Health Partnerships

Title of Manager: Care Coordination Program Manager – Behavioral Health

Supervises: Non-supervisory

Exemption Status: Non-exempt

Requisition ID: 23004

General Statement of Duties

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 Position Functions

• 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to the point that a member is either enrolled with the requested service, an alternative service, or the referral is withdrawn.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.

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.
• Perform other duties as needed.

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

• 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

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

0 hours/day 0 hours/day 0 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 0 hours/day More than 6 hours/day More than 6 hours/day 3-6 hours/day 3-6 hours/day

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.

Education and/or Experience

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.

Working Conditions

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

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.

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.