Resource Specialist, NBMC (Per Diem, Days) Job Listing at NorthBay Healthcare in Fairfield, CA (Job ID 5330)

Description

At NorthBay Health, The Resource Specialist will perform a combination of duties designed to maximize the utilization of hospital resources, improve population health outcomes, and coordinate post-hospital care for patients in support of Population Health Case Management Team. These comprehensive duties include communication and coordination with payers, outside agencies, and other departments to assist with patient discharge and supporting Population Health Case Management Team accountabilities. The Resource Specialist must demonstrate adherence to the department and system policies, procedures, quality assurance, guidelines, and goals of the department, the organization, and the broader population health strategy. The Resource Specialist takes day-to-day direction for priorities from the Utilization Management Manager or designee.

PRIMARY JOB DUTIES

1. Maintains regular communication with Population Health Case Management Team, appropriate management staff, outside agencies, and other hospital departments to ensure a coordinated approach to patient care that supports population health initiatives and equitable access to resources.
2. Prepares necessary paperwork for the Population Health Case Management Team, ensuring it aligns with population health goals by supporting continuity of care post-discharge and addressing social determinants of health.
3. Provides support to the Population Health Case Management Team by faxing, copying charts, making follow-up phone calls, and entering documentation in Cerner and naviHealth per policies and procedures, ensuring that interventions and services provided promote health equity and improved outcomes for diverse patient populations.
4. Initiates and documents Advanced Directive paperwork with patients as directed, including educating patients on options that reflect their cultural and personal preferences, contributing to person-centered care and population health improvement.
5. Initiates, documents, and tracks patient appointments, meetings and care conferences in collaboration with Population Health Case Management Team, supporting timely and effective care transitions that contribute to reducing readmissions and improving population health.
6. Interacts with review organizations, third-party payers, and outside agencies to expedite resources for patient discharge plans, while ensuring resource access is equitable and aligned with patient care goals that enhance population health.
7. Interacts with patients and/or families to provide resource options, including considering social determinants of health and aligning post-discharge care with available community-based services. Alerts the Population Health Social Workers to possible patient intervention opportunities.
8. Assists patients and families with transportation, placement and other      requests for patient needs on an outpatient basis in order to reduce unnecessary ED and inpatient acute utilization
9. Verifies insurance benefits and contracted agencies for patient care options post-discharge, prioritizing care models that support preventative care and enhance population health outcomes.
10. Reviews post-hospital care (SNF, DME, Home Health, Crisis, etc.) in accordance with the interventions and discharge plan created by the Inpatient Case Management team, while ensuring that patient care strategies contribute to reducing health disparities and improving overall community health.
11. Maintains and updates resources on the K drive and notifies the Population Health Team of updates, ensuring resources reflect the most current population health trends and available community programs.
12. Attends and participates in daily huddles, as appropriate, with a focus on identifying opportunities to improve care coordination and overall health outcomes for populations at risk.
13. Upon the request of Population Health Case Management Team, produces and distributes all necessary correspondence, incorporating strategies that promote continuity of care and better post-discharge health outcomes for all patient populations.
14. Produces necessary correspondence, including hospital transfer information, for the Population Health Case Management Team, with a focus on ensuring smooth transitions that reduce readmissions and promote long-term health for diverse populations.
15. Organizational standards for Joint Commission, Department of Human Services, Patient Safety, CMS Conditions of Participation, and the Department of Health will be met, with an emphasis on maintaining quality standards that improve patient health outcomes at both the individual and population levels.
16. Performs audits as assigned, identifying trends that may inform interventions to enhance population health and reduce avoidable healthcare utilization.
17. Performs special functions and other duties as assigned, with attention to addressing the health needs of vulnerable or underserved populations.

1. Education: High school diploma preferred. Bachelor's degree in science field, Medical Assistant, or CNA certification preferred. A background in public health or population health management is beneficial.
2. Licensure/Certification:  None
3. Experience: Two or more years of experience in a hospital or medical setting preferred. Knowledge of medical terminology required. Experience in utilization management, discharge planning, and/or social work preferred. Experience working with diverse patient populations and an understanding of population health management practices are highly desirable.
4. Skills: Excellent organization and communication skills. Able to work independently and collaboratively. Organizes workload and sets priorities using good judgment. Able to handle multiple telephone calls and work with frequent interruptions. Takes initiative; identifies opportunities and follows through on appropriate issues. Good oral and written communication skills required. Proficient in using copiers, fax machines, computers, and other general office equipment. Experience with Microsoft Word, Excel, and Outlook. PowerPoint, Cerner, and naviHealth preferred. Strong commitment to improving health outcomes for populations and reducing health disparities.
5. Physical Effort: Attendance is an essential function of the job. 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. Requires some walking, periods of sitting and standing.  Some stooping, bending, and twisting.  Requires use of computer keyboard throughout the workday. 
6. Hours of Work:  8:00-4:30 p.m. on scheduled days or as otherwise assigned by Manager, UM according to business needs.
7. Compensation note: posted pay range includes a per diem differential