Description
JOB SUMMARY
At NorthBay Health, the Resource Specialist (RS) will perform a combination of duties designed to maximize the utilization of hospital resources and coordinate post-hospital care or offer resources and education for patients in support of Social Services, including supporting Inpatient Case Management and Population Health teams per business needs. This RS position is patient-facing and will primarily serve/support the Social Services department but will be cross trained to also support case management and population health RS roles to collaboratively improve patient access and help reduce readmission.
The responsibilities of these comprehensive duties include communication and coordination with payers and outside agencies to assist with patient discharge and supporting IPCM/Social Work accountabilities. The Resource Specialist at NorthBay Healthcare must be able to demonstrate adherence to the department and system policies, procedures, quality assurance, guidelines and goals of the department and the organization. The Resource Specialist takes day to day direction for priorities from the Inpatient Case Management/Social Work Supervisor, Social Worker or designee.
PRIMARY JOB DUTIES
Maintains regular communication with Inpatient Case Managers (IPCM), Social Workers, appropriate management staff, outside agencies and other hospital departments.
Prepares necessary paperwork for the Social Workers and IPCM.
Provides support to the Social Worker and IPCM: faxing, copying charts, follow-up phone calls, resource education to patients, coordinating Lyft/taxi rides, providing clothes/items to the homeless, tracking of shelter beds, follow-up appointments, with documentation in the EMR system and Navi Health per policies and procedures.
Initiates and documents Advanced Directive paperwork with patients as directed.
Initiates, documents, and tracks provided resources and any items related to discharge planning and disposition (home, shelter, wellness checks, etc.)
Interacts with review organizations, third party payers, and outside agencies to expedite resources for patient discharge plans and maximize hospital reimbursement for services provided. Documents denials, authorizations, and health plan updates in the Electronic Health Record. Appropriately notifies Medical Auditor, Social Worker and/or Supervisor of authorization issues.
Interacts with patients and/or families to provide resource options, as directed.
Verifies insurance benefits and contracted agencies for patient care options post discharge.
Coordinates post-hospital care (SNF, DME, Home Health, Crisis, Shelter bed, etc.) in accordance with the interventions and discharge plan created by the IPCM and/or Social Worker.
Maintains and updates resources on K drive and notifies RS Lead and SW Supervisor of updates.
Attends and participates in patient care rounds, as appropriate.
Upon the request of IPCM or SW, produces and distributes all necessary correspondence.
Produces necessary correspondence, including hospital transfer information, for the IPCM/SW.
Organizational standards for Joint Commission, Department of Human Services, Patient Safety, CMS Conditions of Participation, and the Department of Health will be met.
Performs audits (i.e. Anticipated Discharge Date) as assigned.
Performs special functions and other duties as assigned.
Qualifications
Education: High school diploma preferred. Bachelor's degree in Social Work, Psychology or Health Sciences strongly preferred.
Experience: One or more years of experience in a hospital, medical setting or public health role required. Knowledge of medical terminology required. Experience in utilization management, discharge planning, and/or social services and community-based organizations strongly preferred. Knowledge of local resources preferred.
Skills: Excellent organization, problem-solving and oral/written communication skills. Able to work independently and collaboratively as a team player across the organization. Organizes workload and sets priorities using good judgment. Able to handle multiple telephone calls, research resources, provide patient resource education and work with frequent interruptions. Takes initiative; identifies opportunities and follows through on appropriate issues. Proficient in using copiers, fax machines, computers, and other general office equipment. Experience with Microsoft Word, Excel, and Outlook. PowerPoint, Cerner, EPIC and NaviHealth (WellSky/Careport) preferred.
Interpersonal Skills: Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence. True NORTH Standards (Nurture Care, Own It, Respect relationships, build Trust, Hardwire excellence) This is a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. Ability to demonstrate caring, collaboration, competence, and communication behaviors by communicating effectively with patients/families, physicians, health care personnel, supervisory staff, and peers. Demonstrates open and honest communication. Demonstrates the ability to be organized and efficient in prioritizing and managing assignments with minimal oversight and direction. Demonstrates the willingness to research, learn, and obtain knowledge for the performance of the position. Demonstrates a courteous, professional demeanor and team spirit and the ability to work in a collaborative, effective manner. Utilizes critical thinking and applies sound clinical judgment and assessment skills for decision making. Duties also include but are not limited too:
Coordinate w/community resources (shelter referrals, Lyft, Liaison for social placement, housing resources, Mental Health resources, support groups, insurance resource benefits, etc.)
Complete administrative tasks (such as give out resources per assessment by MSW/LCSW, track shelter beds in collaboration with Population Health Social Workers) .
Follow direction by MSW/LCSW
Call and initiate IP psych transfers with NorthBay transfer center after 5150 placed by telepsych.
Interdisciplinary as well as inter-program collaboration. Assignment will cross between inpatient and outpatient social work needs.
5. Hours of Work: 8:00-4:30 p.m. on scheduled days or as otherwise assigned by IPCM/SW Supervisors according to business needs. May include weekend rotations and will include holidays to meet business needs.
6. Compensation : $31.71- 38.00 per hour based on years of experience
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