Referral Specialist

Community Action Partnerships of Western Nebraska (CAPWN) is a non-profit community-based health and human services organization that serves low-income, disadvantaged and those unable to meet their needs through other sources. The agency was established in 1965 and provides services to over 9,000 individuals, children and families in three main areas:

• Community Health Services
  : WIC, Commodity Supplemental Food, Foster Grandparents, Head Start, and Child Development Center.
• Clinical Health Services
  :
  Primary Care, Reproductive Health, Diabetes Management, Immunizations, Migrant Health, Ryan White HIV;
  Behavioral Health including Counseling Services, Medication Management, Medication Assisted Treatment and Substance Use Counseling and Intensive Outpatient Services and Dental Services.
• Supportive Health Services
  :
  Family Stabilization, a Teen Outreach Program, SOAR, Youth Leadership Program, Youth Shelter and Housing Assistance Programs.

OUR PROMISE
:
Community Action changes people’s lives, embodies the spirit of hope, improves communities, and makes America a better place to live. We care about the entire community, and we are dedicated to helping people help themselves and each other.

VISION

Communities where everyone has an opportunity for a successful life.

MISSION

The Mission Statement of the Community Action Partnership of Western Nebraska is to provide quality services and promote learning opportunities to improve nurture the health and well-being of Western Nebraska communities.

KEY BELIEFS

• Integrity— We treat all people with dignity and respect.
• Compassion— We believe working compassionately with people enriches all.
• Inclusion— We are inclusive and advocate for diversity.
• Collaboration— We believe working in partnerships strengthens communities; we seek mutually beneficial partnerships that advance a common mission.
• Innovation— We embrace opportunities to learn, grow and make wise choices.

COMPETITIVE BENEFITS PACKAGE
:

Fulltime (40 hours)

8:00 AM to 5:00 PM

Monday to Friday

Job Title
:
Referral Specialist

Reports To
:
Primary Care Nurse Supervisor

Areas of Responsibility
:

Ensure the effective management of all external and internal referrals. Schedule, follow-up, and complete referrals for clinic patients. Appropriately document referral progress in the Electronic Medical Record (EMR). Work with clinical staff to ensure appropriate scheduling, notifying the ordering provider when referral appointments are not kept, and preauthorization’s as required. Follow Patient-Centered Medical Home and Federal Tort Claim Act requirements to ensure patient safety.

• Play an active role in patient care using the provider led, Team-Based, Patient-Centered Medical Home Care Model.
• Assemble information concerning patient’s clinical history and referral needs. Per referral guidelines, provide appropriate clinical information to specialists and exchange information with outside entities to verify prior authorizations for procedures.
• Ensure referrals are addressed in a timely manner including sending referrals, scheduling, follow-up, and requesting and receiving records, completing referrals in the patient’s EMR.
• Maintain ongoing tracking and appropriate documentation on referrals to ensure patient safety.
• Complete Preauthorization of procedures with insurance companies.
• Follow-up with the patient or external agencies per CAPWN Referral Tracking policy and procedures.
• Review details and expectations about the referral with patients, including financial assistance programs that are available at the referralsite.
• Assist in training ordering providers and support staff.
• Become knowledgeable of community and CAPWNresources.
• Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers.
• Ensure that a patient’s primary care chart is up to date with information on specialistconsultations, hospitalizations, ER visits and community organization related to their health.
• Attend staff training sessions and meetings as required.
• Maintain confidentiality of records and communications following CAPWN policy and HIPAA privacy and security policies and procedures.
• Maintain a positive and…