The Referral Specialist for Miracle of Love directs a client to needed core medical or support services in person or through telephone, written, or other types of communication. This service may include referrals to assist eligible clients in obtaining access to other public and private programs for which they may be eligible(e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer’s Patient Assistance Programs, and other state or local health care and support services, or health insurance Marketplace plans).
| FLSA Status: Non-Exempt Employee |
| Reports to: Referral Specialist Program Manager |
Position Responsibilities
Provides a range of client-centered services that links clients with health care, psycho-social and other services to insure timely, coordinated access to medically appropriate levels of health and support services, continuity of care, ongoing assessment of the client’s and other family members’ needs and personal support systems, and inpatient case management that prevents unnecessary hospitalization or that expedite discharge, as medically appropriate, from inpatient facilities.
Key Referral Specialist activities include:
- Complete Referral Determination Assessment (RDA) to determine client level of coordinated care:
- Refer clients with a RDA score of one within three business days to OAHS services.
- Refer clients with a RDA score of two to ICM within three business days to complete eligibility.
- Communicate with clients 30 day prior to eligibility expiring. Document all attempts.
- Refer client to EIS if client has fail to communicate after three attempts.
- Facilitate referral to oral health, transportation and nutrition.
- Track referrals to other core medical, support services, and partner services.
- Provide education to clients regarding available benefits programs, assist with applications, provide advocacy with appeals and denials, assist with re-certification and provide advocacy in other areas relevant to maintain benefits/resources.
- Document all consumer progress and contacts in progress notes within 72 hrs. of contact.
- Maintains all required and appropriate documentation for client records and progress notes for assigned cases in accordance with Miracle of Love, Inc. policy and procedures along with Orange County Board of County Commissioners requirements.
- Meets services productivity (direct client services) standard of 28 units per day for the provision of Referral Specialist services in accordance with applicable quality criteria, which are supported by appropriate record documentation, which meet specifications, documentation, requirements with Miracle of Love’s standards.
Essential Skills and Experience:
- Clean criminal history
- Bilingual – Fluent in English & Spanish
- Ability to be an active listener to others and to establish and maintain effective working relationships demonstrating understanding, patience and tact in dealing with clients, personnel and the general public. Demonstrate leadership qualities and the ability to plan, organize and coordinate work assignments.
- Ability to communicate effectively verbally and in writing.
- Ability to establish and maintain relationships, empathizes, and communicates with clients and family members.
- Ability to maintain complete and up-to-date record documentation.
Other Job-Specific
- Completes preliminary assessment process for persons seeking services from Miracle of Love, Inc. to collect information concerning presenting problem, demographic information, and medical history. Documents assessment in accordance with client.
- Initiates admission certification review for all prospective new clients and initiates continued review for all active clients as indicated in accordance with client requirements and agency procedures.
- Completes documentations in accordance with agencies specifications. Completes and /or makes referrals for assessments and evaluation processes in accordance with client needs and/ or treatment team objectives.
- Make appropriate referrals and initiates consultations with Miracle of Love’s component and other agencies and organizations in accordance with client’s needs. Documents activities in accordance with clients.
- Staff appropriate clients with the program supervisor on an initial and periodic basis on accordance with clients.
- Responds to public information requests including giving information by phone as well as one-on-one contact. Visits agencies, organizations and individuals requesting information as directed by the supervisor.
- Completes on-call assignments and provides back up coverage as requested by supervisor in accordance with agency procedures and schedules.
- Monitors client’s participation in planned services in accordance with Miracle of Love’s policy and procedures.
- Completes Miracle of Love’s discharge/transfer summaries for assigned cases in accordance with client. Audits clinical records upon closing/ transfer to ensure full compliance with Miracle of Love’s standards. Initiates corrective action as needed.
- Maintains documentation of all staff activity in accordance with Miracle of Love’s policy and procedures and client specifications.
- Implements quality management (QM) standards based on the Clinical Quality Management (CQM) plan. Review, revise, and update errors in Provide Enterprise (PE) from the QM task form to ensure QM deliverables are met.
- Attends and participates in staff and case management meetings as required.
General:
- Performance Improvement: Initiates efforts to improve job, program, or Agency performance and quality of services. As appropriate, participates in Miracle of Love, Inc. performance improvement initiatives or activities (e.g., work teams, committees, etc.).
- Initiative/ Acceptance of responsibility: Demonstrates self-motivation and self –reliance. Performs additional responsibilities as needed/required.
- Attitude/Customer Relations: Maintains friendly, productive work atmosphere with co-workers Demonstrates positive customer relation skills and shows respect and courtesy for clients, other employees, and the public.
- Attendance: Observes assigned work hours, use and scheduling of leave, and punctuality.
- Training and Education: Maintains compliance with required training in accordance with established time frames. Seeks opportunities to increase knowledge and competencies, which benefit the position, program or Agency.
License: Must possess a valid Florida driver’s license or have access to reliable transportation.
Physical demands and work environment
- Physical demands: While performing the duties of this job, the employee is occasionally required to walk, sit; use hands to fingers, handle or feel objects tools, or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job included close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Physical or mental ability to carry out the activities of position responsibilities.
- Work environment: While performing the duties of the job, the employee is exposed to bodily fluids, weather conditions prevalent at the time of duty. The noise level is usually minimal to moderate.
Salary Range Starting: $35,000