Transportation Coordinator - Patient Coordination - Oregon or SW Washington
Location: Portland, Oregon
Type: Full Time
Hospital, Public and Private
Internal Number: 19869
General Statement of Duties
This position is responsible for authorization and coordination needs for transportation under the Non-Emergent Medical Transportation (NEMT) benefit. This position will be primarily responsible for coordinating services between NEMT brokerages, medical facilities, and directly with members to ensure appropriate transportation is provided. This role will foster improved access to care for members; assure compliance of services within program requirements; provide detailed program information; and confer with medical care and transport providers, members, and internal teams in order to make critical decisions regarding appropriate health care services.
Essential Position Functions
Track and interpret current Coordinated Care Organization activity, state and federal program regulations and requirements relative to Oregon Health Plan NEMT program; seek guidance from internal legal/regulatory staff as needed.
Engage with NEMT brokerages, transport provider networks, medical providers and clinics, and members to coordinate special need transportation services.
Monitor the activity of the transport function and transporters; ensure timely and efficient completion of requests and related tasks.
Utilize effective dispatching logic in prioritizing tasks and dispatching assignments to the appropriate internal and external personnel.
Assist in coordinating member transport activities and services with other departments.
Monitor the cost and utilization based on unique membership utilization and overall ridership trends by ride type and program type.
Identify problems, conduct research, resolve or make recommendations to resolve individual and larger trend issues.
Coordinate the development and tracking activities for performance metrics to enhance program quality on a regular monthly basis.
Gather and clean NEMT encounter and claims data to supervisor and business owners on a regular monthly basis.
Review and monitor regulatory documents and templates to report and present data to program supervisor and business owners on a regular quarterly basis.
Participate in public hearings; represent CCO in contested case hearings as needed.
Perform other duties as assigned.
Essential Departmental and Organizational Functions
Propose and implement process improvements
Meet deadlines for completion of workload
Maintain agreed upon work schedule
Demonstrate cooperation and teamwork
Provide cross-training on specific job responsibilities
Meet identified business goals that contribute to departmental goals
Follow established department policies and procedures
Perform other duties and projects as assigned
Knowledge, Skills and Abilities Required
Knowledge of Medicaid programs, Oregon Health Plan, CCOs preferred
Knowledge of state and federal regulations of Non-Emergent Medical Transportation benefit preferred
Ability to use good judgement, personal initiative and discretion to perform work with particular attention to detail
Ability to work both independently and within a team, and to use good judgment about when to ask for assistance or direction.
Effective administrative support and coordination skills
Proficient with Word, PowerPoint, Access and Visio to collect, review and display information
Ability to produce, store confidentially, and retrieve provider contract documents
Ability to work under pressure in a complex and rapidly changing environment
Ability to work in a community (internal and external) with diverse individuals and groups
Ability to anticipate next steps and be proactive
Ability to handle confidential information with discretion
Ability to gather, compile and analyze data
Strong research and sound problem solving skills
Excellent customer service, written and verbal communication skills
Knowledge of basic concepts of managed care and contract language or ability to learn quickly
Education and/or Experience
Minimum two years’ experience coordinating patients, projects, programs, or daily department operations required, preferably with a health plan or healthcare focus; a Bachelor’s degree in Health, Social Services, or related field and minimum one year experience in project/program/department coordination or administrative experience may be considered in lieu of the two years’ experience.
Environment: This position’s primary responsibilities typically take place in the following environment(s) (check all that apply on a regular basis):
? Inside/office ? Clinics/health facilities ? Member homes
Travel: This position may include occasional required or optional travel outside of the workplace, in which the employee’s personal vehicle, local transit, or other means of transportation may be used.
Equipment: General office equipment
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment
Veterans are strongly encouraged to apply.
Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
CareOregon is making a difference. Join us. For people who care about helping others, CareOregon is the place to be. We’re a nonprofit health plan dedicated to providing access to high-quality, cost-effective, culturally competent care for Oregon Health Plan and Medicare Advantage participants. For compassionate innovators committed to improving health care throughout Oregon, we offer a great work environment where your contributions are recognized. CareOregon’s culture emphasizes collaboration among our employees, members, providers and community partners. We are driven by our values, woven with responsibility, passion, initiative and empathy. Join us because you’ll be part of a growing nonprofit health plan that has been at the forefront of health reform and health care innovations for more than 25 years.https://www.careoregon.org/careers/