Care Management Referral Specialist

Are you a motivated individual with a keen ability to follow through on tasks big and small? PCHC is looking for a Care Management Referral Specialist to join our dynamic and growing team! In this role, you’ll track all care management referrals and provide a comprehensive and positive referral experience to our patients, playing a vital role in connecting them to the Care Management services and resources they need. We’re looking for someone who is resourceful, detail-oriented, has excellent follow-through skills, and who is ready to make a difference. Sound like you? Apply today!

What’s it like to work at PCHC? Find out: https://www.youtube.com/watch?v=GyC3DFYq0zg

Schedule: Full-Time, Monday-Friday, 8am-4:30pm (Candidate must be able to train and onboard in Bangor, Maine for the first 6 months of employment. Hybrid remote schedule possible after the 6-month training period and depending on the needs of the Care Management department. Candidate must be eligible per PCHC’s Telecommuting policy.)

Highlights of the position:

• Provides excellent customer service to our patients, staff, and external customers by demonstrating friendliness, helpfulness, and proficiency. 
• Utilizes MaineCare Health PAS and VMS portal systems to screen patients for eligibility to Care Management programs.
• Accurately and efficiently processes referral and prior authorization requests for Care Management Services. Verifies insurance benefits to ensure services are covered and communicates with the ordering provider for any referral-related questions and/or issues.
• Properly scans, imports, and processes patient health information related to referrals,  ensuring all work is appropriate, compliant, and all protected information redacted.  
• Serves as a liaison and point of contact with community resources and prospective case management clients regarding Care Management referrals.  
• Is a good steward of health information management. Understands and follows applicable HIPAA laws and regulations and PCHC medical records policies.
• Engages and supports patients to ensure they feel heard, respected, and involved in their care and experience. Collaborates with Care Management teams and clinics to improve the patient experience and referral processes.

Join PCHC's nationally recognized non-profit organization:

• Federally Qualified Health Center offering integrated Medical Home Model
• Collegial professional atmosphere with informed leadership
• Flexible schedules supportive of work/life balance
• Competitive compensation and generous benefits
• PCHC cares for the WHOLE person, offering a broad range of services, including Psychiatry & Mental Health, Dental, Family Medicine, Pediatrics, Pharmacy, Geriatrics, Lab & X-Ray, Physical Therapy and Podiatry all within one organization.

EDUCATION AND EXPERIENCE:

• High school diploma or equivalent required.
• Associates in Medical Office Technology, Health Information Management or other relative post-secondary degree is preferred.
• At least one year of experience in a customer service setting required
• Two years of experience in a healthcare office setting preferred.
• Completion of a Medical Terminology I course preferred.
• Having a valid driver’s license with an acceptable driving record and/or an appropriate length of driving experience for insurance purposes is required. Any concerns raised by the results of a driving record check will be subject to an individualized review to determine whether the infraction is relevant to the individual’s ability to perform the responsibilities of the position in accordance with PCHC’s Automobile Safety and Background Check Policy.

Curious, or interested to learn more? Apply today! You can request a full copy of the detailed job description by emailing recruitment@pchc.com.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or any other characteristic protected by law.