Health Resource Coordinator- Disease- Health Plan

Parkland Health•Tulsa, OK

3d•Hybrid

About The Position

PCHP- Parkland Community Health Plan Primary Purpose The Health Resource Coordinator (HRC) delivers quality service to all members and other customers using the whole person care approach of excellence and respect. Performs member outreach for enrollment and ongoing member participation in our disease management clinical programs. Minimum Specifications Education High school diploma or equivalent required Associate degree preferred Experience Minimum 2 years' experience working in a medical office setting, telephone customer service representative or telemarketing representative required. Direct experience in a telehealth function preferred. Equivalent Education and/or Experience May have equivalent combination of education and /or experience in lieu of education Skills or Special Abilities Strong communication skills -oral and written Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible Ability to assist member in navigating the healthcare system and community -based resources Culturally sensitive and competent for assigned membership Strong organizational skills, ability to multi-task Ability to determine when to escalate issues appropriately and in a timely manner Proficient computer skills Bilingual preferred (Spanish) Responsibilities Member Outreach Respond to inbound calls from members, physicians, clients, or other individuals addressing needs in accordance with department policies and procedures. Conduct outbound calls to members for enrollment purposes, customer satisfaction surveys, or other matters as assigned. Serve as a member advocate ensuring the best possible service is provided. Demonstrate cultural sensitivity and competency for assigned members. Escalate member issues and concerns to the appropriate level for assistance in a timely manner. Disease Management Program and Resource Coordination Perform member outreach for enrollment and ongoing participation in clinical programs for disease management. Provide ongoing support to program participants from enrollment through program completion through established processes. Connect member with appropriate programs and community resources to ensure ongoing quality of care. Assist members with navigating the healthcare system and community-based resources. Obtain authorization numbers for referrals when necessary. Documentation Documentation is clear, thorough, and entered timely. Maintain appropriate documentation for member outreach and disease management program/resource coordination activities. Collect and validate member demographics including contact information and preferences. Route messages to the appropriate nurse and enter pertinent notes into the documentation system. Manage correspondence with providers, members, and health plan staff. Regulatory Ensures work is carried out in compliance with regulatory and/or accreditation standards as well as contractual requirements. Professional Accountability Promotes and supports a culturally welcoming and inclusive work environment. Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values. Adheres to organizational policies, procedures, and guidelines. Completes assigned training, self-appraisal, and annual health requirements timely. Adheres to hybrid work schedule requirements. Attends required meetings and town halls. Recognizes and communicates ethical and legal concerns through the established channels of communication. Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information. Maintains confidentiality at all times. Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies. Parkland Health, one of the nation’s largest public hospital systems, is dedicated to delivering exceptional care to the Dallas community. A career at Parkland means joining a collaborative, engaged team focused on excellence, innovation, and patient-centered service. Our employees are supported with resources to grow, succeed, and make a meaningful impact every day.

Requirements

High school diploma or equivalent required
Minimum 2 years' experience working in a medical office setting, telephone customer service representative or telemarketing representative required.
Strong communication skills -oral and written
Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible
Ability to assist member in navigating the healthcare system and community -based resources
Culturally sensitive and competent for assigned membership
Strong organizational skills, ability to multi-task
Ability to determine when to escalate issues appropriately and in a timely manner
Proficient computer skills

Nice To Haves

Associate degree preferred
Direct experience in a telehealth function preferred.
Bilingual preferred (Spanish)

Responsibilities

Respond to inbound calls from members, physicians, clients, or other individuals addressing needs in accordance with department policies and procedures.
Conduct outbound calls to members for enrollment purposes, customer satisfaction surveys, or other matters as assigned.
Serve as a member advocate ensuring the best possible service is provided.
Demonstrate cultural sensitivity and competency for assigned members.
Escalate member issues and concerns to the appropriate level for assistance in a timely manner.
Perform member outreach for enrollment and ongoing participation in clinical programs for disease management.
Provide ongoing support to program participants from enrollment through program completion through established processes.
Connect member with appropriate programs and community resources to ensure ongoing quality of care.
Assist members with navigating the healthcare system and community-based resources.
Obtain authorization numbers for referrals when necessary.
Documentation is clear, thorough, and entered timely.
Maintain appropriate documentation for member outreach and disease management program/resource coordination activities.
Collect and validate member demographics including contact information and preferences.
Route messages to the appropriate nurse and enter pertinent notes into the documentation system.
Manage correspondence with providers, members, and health plan staff.
Ensures work is carried out in compliance with regulatory and/or accreditation standards as well as contractual requirements.
Promotes and supports a culturally welcoming and inclusive work environment.
Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values.
Adheres to organizational policies, procedures, and guidelines.
Completes assigned training, self-appraisal, and annual health requirements timely.
Adheres to hybrid work schedule requirements.
Attends required meetings and town halls.
Recognizes and communicates ethical and legal concerns through the established channels of communication.
Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information.
Maintains confidentiality at all times.
Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies.