Hourly Rate: $25.00 per hour

Employee Benefits: Medical, Dental, Vision all with Carefirst Blue Cross Blue Shield, Paid Time Off (Vacation, Sick, Personal, Holidays), 403B Plan, Short-Term & Long Term Disability, Life Insurance. 

Telework:This position is approved for hybrid in-person and telework. Job duties require at least three (3) days a week onsite at assigned health center site/s. Job duties also require in-person meetings and collaboration with other staff at PCC.  This role is approved for telework when activities do not require a physical presence.  Note: PCC employees must reside in the following five states or District of Columbia: MD. VA, WVA, DE. PA, DC.  Relocation expenses are not reimbursed.  

The Bilingual Referral Specialist ensures that patients receive smooth access to specialty care appointments and surgical procedures and works with a highly diverse patient population who speak over 60 languages. The Bilingual Referral Specialist performs core operational duties for the specialty care referral network. This includes processing referral requests, confirming patient eligibility, scheduling appointments, coordinating surgical procedures, and supporting follow-up care. This role is perfect for someone who is detail oriented, comfortable with medical terminology, and a great communicator. The Bilingual Referral Specialist will need to prepare patients for their appointments and surgical procedures. For surgical procedures, The Referral Specialist synthesizes pre-operative, peri-operative, and post-operative instructions to ensure successful surgical procedure coordination and communicates this information to all involved parties, including patients. In collaboration with the Clinical Lead Nurse, the Referral Specialist facilitates any preoperative clearances required from other medical specialists. Following the specialty care appointments, Referral Specialist receives consult notes, provider’s orders, and other information provided by the specialty care offices and uploads them into the referral database for ongoing care coordination. The Bilingual Referral Specialist must be highly responsive and flexible to address unexpected medical care coordination needs as they arise.

Primary Responsibilities

• Reviews Eligibility and Required Documentation for Appointment Scheduling. This involves working with the referring primary care health centers and the patients to ensure that they are active program participants and all the necessary clinical and demographic intake forms are complete.
• Ensures that referring health centers upload proof of residency and income documents into the case management system for Endocrinology and Oncology referrals.
• Communicates with health center staff on a case-by-case basis to request missing documentation, especially when financial aid is required for laboratory services.
• Reviews eligibility dates in the case management system to confirm medical care coverage for the patient.

2. Schedules & Coordinates the Initial Appointment. Schedules and coordinates patient appointments with the appropriate specialist, ensuring timely access to care. Maintains accurate documentation and facilitates communication between patients, specialists, and referring health centers.

● Documents appointment details into the referral system and sends referrals and all supporting documents to specialists via fax or encrypted email.
● Secures specialist availability for program participants and communicates with specialists to request approval before scheduling.
● Communicates appointment details to the referring health center and the patient.
● Confirms upcoming scheduled appointments with patients, reviewing responsibilities and any specific office details.
● Ensures all pertinent paperwork, doctor orders, and instructions are sent to patients in a timely manner.
● Mails referral documents to patients.

3. Supports Follow-up & Coordination after Initial Visit. Ensures continuity of care by managing follow-up tasks after the initial specialty visit. Maintains accurate documentation, facilitates communication, and supports timely processing of additional referral requests.

● Gathers and uploads consult notes, provider orders, and other information received by fax, mail, or encrypted email into the referral database.
● Notifies the referring primary care health center and Clinical lead or Call Nurse that notes and orders have been uploaded to the referral database.
● Processes referral requests for lab work, imaging, and follow-up visits by entering them into the referral database upon receipt from patients or specialists. Educates external stakeholders, including referral coordinators at health centers and specialty care provider staff, on program guidelines and the referral submission process to ensure accurate and timely coordination of care.
● Requests patient medical records from specialty care offices or facilities, as needed.
● Communicates time-sensitive follow-up appointments or care coordination needs to Project Access clinical staff and the primary care health center team.

4. Surgical Procedure and Complex Care Coordination. Oversees the coordination of surgical procedures by ensuring preoperative requirements are met, facilitating seamless communication between providers, and guiding patients through the surgical process. Manages preoperative scheduling, clearances, and necessary documentation while keeping all stakeholders informed. Works closely with primary care health centers, hospitals, and specialists to ensure timely and efficient surgical care.

● Receives procedure requests from specialists and uploads preoperative requests and orders to the referral database.
● Assists Clinical Lead Nurse and On-call Nurse in coordinating complex specialty care referrals including assisting with translation and completing Maryland Cancer Fund applications with patients.
● Provides care coordination support to patients who have multiple comorbidities and require referral to multiple specialists.
● Notifies the On-Call Nurse and Clinical Lead Nurse of procedures requiring clinical or administrative review or approval.
● Coordinates and schedules preoperative care or clearances between the program, primary care health center, hospital, and surgeon’s office. 
● Notifies the clinic of the patient's scheduled procedure date, communicate specialist requirements for the procedure, send preoperative requests, and coordinate the scheduling of pre-op appointments.
● Synthesizes and communicates preoperative, perioperative, and post-operative instructions to all involved parties.
● Follows up with the health center to ensure the patient is scheduled for a preoperative exam.
● Contacts patients to inform them of procedure copays and coordinate preoperative care, including exams, labs, and imaging.
● Follows up after the preoperative exam to request notes, labs, EKGs, and imaging from the primary care health center.
● Reviews preoperative notes to confirm the patient is cleared for surgery and all requested testing is complete.
● Sends all preoperative notes, test results, and referrals to specialists, hospitals, anesthesia, pathology, and surgery center finance offices.
● Ensures the patient receives all necessary referrals and supporting documents in a timely manner.
● Obtains procedure notes and post-operative appointment details after the procedure and processes the referral to be mailed to the patient and sent to the specialist’s office.
● Responds to phone or email inquiries from patients, health center staff, and community members.

5. Training and Operational Improvement and Support. Provides training to parties involved in care coordination, participates in improvement efforts, and provides operational support to ensure smooth care coordination. 
● Trains health center staff on specialty care referral workflows and requirements.
● Engages in periodic meetings with health centers and specialist teams for training refreshers, onboarding, workflow coordination, and patient care coordination.
● Updates the Program Director and Clinical Lead Nurse with any changes to staffing or availability at health centers or specialty care offices.
● Assists the On-Call Nurse and Clinical Lead Nurse in effectively communicating and coordinating with patients, health center staff, and specialist offices.
● Engages in Project Access and Healthcare Access Team meetings and for process improvement activities. 
● Brings forward thinking ideas and solutions to problem solving.
● Manages incoming and outgoing faxes and mail related to specialty care coordination.

Additional Responsibilities

● Works with patients, health centers, and vendors to resolve patient bills if patients have been billed by hospitals or providers in error.  
● Represents the program within PCC and to external stakeholders as assigned, in a professional and informed manner
● Participates fully and collaboratively in ongoing Specialty Care and Medicine Access and PCC workgroups and quality improvement initiatives as requested
● Other program responsibilities as assigned by Director or Clinical Lead. 
● Participate in at least one departmental or organizational improvement project each year.
● Translates documents, as needed. 
Other duties as assigned

Skills and Abilities

● Knowledge, understanding, and interest in supporting safety net health centers and their vulnerable patients  Excellent written and verbal communication skills.
● Strong interpersonal skills with ability to interact effectively and build collaborative relationships with specialists, health center team members, and PCC team members.  
● Ability to prioritize work, manage time effectively, and meet time sensitive deadlines 
● Understanding and aptitude to learn medical terminology. 
● Ability to break down complex medical information and communicate effectively with health center team members and patients.
● A strong orientation to detail generally and specifically with entering data. 
● Ability to travel to PCC’s network of health centers in Montgomery County.
● Ability to quickly learn and master software. 
● Ability to handle sensitive communications, interface with individuals in crisis while providing excellent customer service.
● Strong organizational skills, ability to prioritize  tasks, and ensure goals and assignments are completed on time.
● Team player but also has the ability to work independently when required.
● Highly proficient in Microsoft Office (Word, Teams, Excel, PowerPoint, SharePoint, etc.) Adobe Acrobat, MS Teams, Zoom, SharePoint, computers, common office equipment (fax, copy machine, etc.), and medical software.
● Bilingual English/Spanish required.

Education and Experience

● Associate degree or High school diploma or GED required, Bachelor’s degree in Healthcare Administration, Public Health, Business or other relevant fields desirable or may be considered in lieu of experience.
● 3+ years of experience working in healthcare setting and performing care coordination or patient navigation responsibilities. 
● 2+ years of personal or professional experience working with underserved populations and patients with limited English proficiency preferred.
● Fluent in Spanish required. Fluency in other languages is a plus and highly desirable (Amharic, French, Portuguese, Mandarin, etc.)

ADA Requirements

This job operates in a professional office environment.  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

● This role routinely uses standard office equipment such as computers, telephones, photocopiers, filing cabinets, and fax machines. 
● This is largely a sedentary role; however, some filing may be required. 
● This would require the ability to lift files, open filing cabinets, and bend or stand as necessary.  
● Requires ability to learn new software applications as necessary.
● Must be able to lift up to 20 pounds.  
● Must be able to travel locally.

Disclaimer

This job description indicates in general the nature and levels of work, knowledge, skills, abilities and other essential functions as covered under the Americans with Disabilities Act expected of an incumbent.  It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of an incumbent.  An incumbent may be asked to perform other duties as required. Primary Care Coalition is an Equal Opportunity Employer. 

Primary Care Coalition is an Equal Opportunity Employer.