Care and Outreach Specialist - PHP - Telephonic - ...

Essential Responsibilities Outreach and Healthcare System Navigation 'Receive completed health risk assessment and/or screening informationand review all available and relevant member information to identifyunmet physical, behavioral, social, cognitive, or medical needs. 'Proactive member outreach to identify and assess care coordinationneeds. ' Provide short-term care planning to manage identified needs.' Determine and address navigation, care coordination and/or resourceneeds while balancing cultural factors, social determinants, and memberautonomy. ' Coordinate referrals as applicable. ' Address members'navigation needs and identify potential resources. ' Assume directhealthcare navigation for members and provide warm handoff of memberswith complex medical or behavioral health needs to appropriate carecoordination staff. ' As able to identify suspected abuse and neglectissues and appropriately report to mandated authorities. ' Collaborateand facilitate services that meets the member's personal needs, valuesand preferences with physical health, dental health, behavioral healthtreatment providers (i.e., crisis services, Department of DevelopmentalDisability, APD, Department of Human Services (DHS), etc.). ' Coachmembers in navigating the health care delivery system, gaining access toappropriate community resources, and determining ways to improveself-management and satisfaction with their quality of life. ' Inputinformation into the centralized care coordination platform and documentall related activities. ' Provide cross-training on specific jobresponsibilities. Compliance ' Maintain compliance with all contractualand regulatory requirements. ' Maintain timely and accuratedocumentation about each member per program policies and procedures. 'Maintain working knowledge of COA and OHP benefits including physicalhealth and behavioral health. ' Maintain compliance with the Model ofCare requirements if applicable. ' Review and/or audit health riskassessment and/or screening information to inform or evaluatedepartmental, organizational metrics and regulatory requirements. 'Contribute to continuous process improvement through participation inteam huddles, training, departmental, team, and organizational meetings.' Organize, facilitate, and track member care planning andinterdisciplinary care team completion. ' Assist in proactive casefinding; provide documentation and facilitation of care coordination inrelation to a member's change in health status. ' Maintain timely andaccurate documentation about each member per program policies andprocedures. Experience and/or Education Knowledge, Skills and AbilitiesRequired CareOregon is an equal opportunity employer.& #8239;

Created: 2026-04-02