Healthcare Liaison

HEALTHCARE LIAISON

JOB TITLE: Healthcare Liaison

STATUS: Non-Exempt, Full Time

REPORTS TO: RN-Social Case Manager

This job description is intended to be a general statement about this job and is not to be considered a detailed assignment. It may be modified to meet the needs of the organization.

JOB SUMMARY

Under the direction of the RN Social Case Manager, the position is responsible for outreach and enrollment for the network Enhanced Care Management (ECM) program as well as facilitating care management services that promote equitable access to care, quality outcomes, and total cost of care. The Enhanced Care

Management program (ECM) is a new statewide Medi-Cal benefit available to eligible members with complex needs, including access to a support team that provide comprehensive care management and coordinate health and health- related care and services.

The ECM care plan interventions will focus on helping patients navigate the social barriers of achieving diligent care and ensuring quality outcomes. The Health Care

Liaison will work directly with the managed care payer, health center staff and clinicians, and community-based organizations to ensure that the patient is enrolled into the ECM program and that the patient is actively working within their individual care plan as outlined by the social case manager. The liaison will document ECM outreach and care plan of status and ensure effective communication between the patient, clinician, social case manager, and community-based organizations. The Health Care Liaison will be a patient advocate to ensure enrollment and access to services needed.

Created 06/2023

ESSENTIAL JOB FUNCTIONS

• Utilize payer or network reports to outreach to ECM eligible patients to enroll into the ECM program.
• Educate the patient on the ECM program, their benefits, and the support services outlined in the program.
• Become a patient advocate for ECM patients to ensure care plan compliance.
• Engage with the patient and communicate any non-compliance of care plan or healthcare challenges to the social case manager or health center clinical team.
• Document all patient engagement in the designated tools as outlined by the ECM program. (payer or network)
• Work closely with the RN Social Case Manager to report barriers to care and implementation of interventions outlined in the plan of care.
• Help patients navigate and access medical and community resources to help improve health outcomes and overcome social barriers that impede health.
• Establish relationships with community-based organizations and managed care payers to ensure successful engagement within the ECM program.
• Facilitate and coordinate care needs for identified in plan of care that promote quality and controls cost.
• Provide social support and advocate for ECM patients to address community health needs.
• Coordinate care that is safe, timely, effective, efficient, equitable, and client centered based on the care plan developed by the health center clinician or social case manager.
• Assist with community outreach, such as home visits, health assessments and involvement in clinical community intervention activities as assigned.
• Build trusting relationships with patients with a goal to decrease health disparities.

Other

• Develop team members, payer, health center relationships to ensure effective communication that benefits the patients.
• Meet annual goals outlined by leadership that align with the network strategic plan.
• Actively participate in staff meetings and training.
• Perform other duties as assigned.

QUALIFICATIONS:

• High School Diploma or GED
• CPR Certified- Preferred

Education/Experience

• Working knowledge of regional health disparities and social determinants of health.
• Working knowledge community-based organization services.
• Strong interpersonal skills to work effectively internally and externally and across all levels in an organization.
• Working knowledge of relevant computer systems and software.
• Must have excellent written and verbal communication skills.
• Must possess valid driver’s license, insurance, and own transportation for use in work, and be flexible with working some evenings and weekends within a 40- hour workweek.
• Must reside in San Diego County.
• Must be willing to travel, as needed.

Other Required Skills/Abilities

PHYSICAL REQUIREMENTS

• Ability to sit or stand for extended periods of time
• Ability to reach, bend and stoop
• Physical ability to lift and carry up to 20 lbs.
• Office setting.
• Frequent, daily use of computer, telephone, copier and FAX machines.
• Regular periods of high stress and long days
• Must be responsive to multiple deadlines.

HIPAA/COMPLIANCE

• Maintain privacy of all patients, employee and volunteer information and access it only on a need-to-know basis for business purposes.
• Comply with all regulations regarding corporate integrity and security obligations. Report Unethical, fraudulent, or unlawful behavior or activity.

Please note:

“We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law”.

*Salary range is based off geographic location

Job Type: Full-time

Pay: $50,000.00 - $60,000.00 per year

Benefits:

• Dental insurance
• Disability insurance
• Flexible schedule
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Experience level:

• 1 year

Schedule:

• 8 hour shift
• Monday to Friday

Travel requirement:

• Up to 100% travel

Work setting:

• In-person

Language:

• Spanish (Required)

License/Certification:

• CPR Certification (Required)

Work Location: In person