Program Specialist

Overview

Get to know Summit Pacific Medical Center:
Your trusted partner in Health and Wellness. Summit Pacific is a vibrant and expanding public hospital district that operates a Critical Access Hospital with a Level IV trauma designation, three rural healthcare clinics, and a seven-day-a-week urgent care clinic. Our vision is “Through Summit Care, we will build the healthiest community in the Nation.” Our hospital is unique due to its size and accessibility.

We pride ourselves on our ability to give patients quick access to a provider.

• Critical Access Hospital
• 24/7 Emergency Department
• Level II Cardiac Center
• Level III Stroke Center
• Level IV Trauma Care

To learn more about Summit Pacific, visit Pay Range (depending on experience): $23.27 – $32.47.

The Program Specialist is responsible for coordinating and managing the administrative tasks related to patient care for their assigned clinical service line. They serve as a primary point of contact for patients, assisting them with scheduling appointments, providing information about clinical services and insurance processes, submitting necessary orders, processing referrals, confirming authorizations, and ensuring a smooth and efficient patient experience. The Program Specialist works closely with healthcare professionals, including providers, technicians, clinical support staff, and the Patient Access Department, to facilitate the delivery of high-quality care to patients.

• Schedule appointments, consultations, follow-up visits, and other related appointments for patients within their service line(s).
• Coordinate with Patient Access, management, providers, technicians, and other healthcare staff to ensure optimal scheduling and utilization of resources.
• Coordinate durable medical equipment (DME) as needed by department.
• Communicate appointment details and instructions to patients, including any necessary preparations.
• Serve as the expert on patient access workflows for their assigned service line(s), address inquiries, provide information, and ensure effective communication.
• Educate patients on pertinent procedures and policies, including preparation instructions, duration, and expected outcomes.
• Answer phone calls, respond to emails, and handle other forms of communication promptly and professionally.
• Maintain patient records, ensuring accuracy and confidentiality of information.
• Coordinate referrals to and from other healthcare providers/service lines, as needed, and ensure appropriate documentation is obtained.
• Obtain necessary authorizations, insurance verifications, and pre-certifications needed for services.
• Verify acquisition of referrals and pre-authorizations for applicable services.
• Monitors for referral or authorization expirations and proactively seeks extensions.
• Monitors and closes inactive referrals when unable to schedule due to lack of patient contact.
• Support department initiatives by working waitlists and special projects/patient lists as needed.
• Collaborate with providers, clinical staff, and technicians to ensure seamless coordination of patient care.
• May include EPIC template manipulation such as builds, blocking, and holds. (If working in specialty areas this may be more frequent.)
• Follow up with patients to provide test results, orders, answer questions, and address concerns.
• Perform all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
• Consistently demonstrate SPMC values and provide all patients/customers with an excellent service experience.
• Performs special projects and other related duties as assigned.

• Staff Member Responsibilities:
  Adapts to changes in the work environment; asks clarifying questions and/or provides constructive input in a helpful and respectful manner.
• Builds and maintains working relationships:
  Maintains effective working relationships with supervisor and direct co-workers.
• Creates positive experiences for patients, customers and co-workers:
  Consistently provides a level of service that meets SPMC standards.
• Demonstrates ongoing learning & development:
  Partici…