Clinical Support Specialist - Care Management; CSS - CM

Clinical Support Specialist - Care Management (CSS - CM)

1 day ago Be among the first 25 applicants

Get AI-powered advice on this job and more exclusive features.

Location
:
Hybrid. Most of the positions at YCCO are hybrid, meaning they have the flexibility to work both remotely and in-person at YCCO's office in McMinnville, OR.

Department: Health Plan Operations.
FLSA Status: Exempt (Salaried)

Division: Care Management.
Physical Strength: Light (L)

Reports To: Health Services Supervisor.
Work Location Type: Hybrid

About Us: Yamhill Community Care is a nonprofit coordinated care organization dedicated to managing the healthcare for Medicaid members, covered under the Oregon Health Plan, in Yamhill County, as well as parts of Washington and Polk Counties. Our mission is to improve the quality of life of the communities we serve by coordinating effective care. Beyond healthcare, we also provide an Early Learning Hub, supporting families and children with essential resources and programs for early childhood development.

Together, we’re building a unified healthy community that celebrates physical, mental, emotional, spiritual, and social well-being.

Learn more about Yamhill Community Care:

The Clinical Support Specialist (CSS) will work in-person and remotely to perform all aspects of the outlined case management support duties, performing engagement and coordination activities at the individual, community, and health plan levels for chronically ill Medicaid members with diagnoses to include chronic kidney disease, diabetes, COPD, and cardiovascular disease, priority population members and members with mental health and substance use issues.

This position is responsible for administering assigned tasks, performing health assessments, and escalating identified member services issues. Works in collaboration and continuous partnership with members, families / caregivers, clinical support staff, clinic providers, and community resources in a team approach, supports the patient’s ability for self-management and improve member outcomes.

• Administers member identification and engagement.
• Collaborates with YCCO staff and community partners to ensure positive outcomes for members and serves as a liaison between care managers, providers, and members to support comprehensive communication and education.
• Ensures documentation reflects clinical support activities performed and is aligned with regulatory requirements.

• Consults with colleagues and community partners to ensure all members requiring care coordination or case management services are readily identified by the CCO.
• Reviews and processes referrals, ensures appropriate monitoring, evaluates and reports on multi-agency referral and home visiting systems and makes appropriate referrals both internally and externally to appropriate departments / resources.
• Completes outreach calls to identified priority population members for specific case management programs.
• Provides direct member service including responding to incoming calls and routing to appropriate person/department.
• Directs and assists members in completing Health Risk Assessments to identify coordination needs and begin the care planning process.
• Advocates for members / families where member concerns are heard, access to providers is facilitated, and community resources are made available.
• Utilizes expertise to ensure identification and outreach to selected high-risk individuals by working with providers, partners, staff, and other care team members.
• Uses motivational interviewing to coach members towards improved healthcare behaviors.
• Performs work that includes the member, family members, providers, and care team participants to evaluate participant’s health conditions, make recommendations to participant on preventative and follow‑up care; and educating participants on condition(s) and risk, including when condition(s) are worsening.
• Generates and creates community confidence in YCCO programs and services by embracing and exhibiting the Vision and Mission of YCCO.
• Provides excellent customer service, meets the needs of clients while interacting in a respectful…