One element that distinguishes Clinicas del Camino Real, Inc. from the rest is the compassion with which we deliver our services to the general and underserved population in our community. We are proud to have a family of professional and caring individuals who together comprise such a significant entity in the county of Ventura. Ever since our first health center opened its doors over forty years ago, we have continued to grow, improve and expand our services. It certainly would not be possible to accomplish this without the dedication, commitment and ownership that our workforce takes over this prestigious health care organization. If you are someone who wants to work for an organization that makes a difference and have a desire to make an impact on the wellbeing of our local community through your work, we encourage you to apply to become part of our team!
For the Provider Job Listing, please visit Provider Opportunities page.
The following job openings are currently available:
Billing Specialist
Billing
Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
This position will work under the supervision of the Billing Manager. The Billing Specialist will be responsible for the completion of all tasks to ensure accurate, compliant and timely billing of patient charges for appropriate reimbursement from all sources, such as patients and all other third party payers. Billing Specialists will interact with a multi-cultural population of diverse socioeconomic backgrounds, ages, and level of education.
The Billing Specialist is responsible for performing the following duties:
- Reviews charges, payments and adjustments to ensure accuracy and compliance with billing, coding and any contractual requirements
- Generates paper or electronic claims and submits them to all third party payers such as Medi-cal Medicare, private insurances and other programs
- Generates patient statements and collection letters
- Enters payments received from payers and patients in the practice management system
- Reviews claim rejection queue and resolves for resubmission
- Follows up on denied and unpaid claims; works closely with payersto provide any information necessary to receive payment
- Reviews and collects on overdue patient balances
- Answers questions from patients, staff and payers
- Reviews and processes requests for adjustments, corrections or refunds
- Prepares billing reports
- Collaborates and communicates with other team members to ensure efficiency of processes
- Maintains billing records
- Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.
- Must possess a high school diploma or equivalent. A certification or some college work in medical terminology, billing and coding, business or accounting, and business communications is desirable.
- Must have knowledge of Current Procedural Terminology (CPT) and International Classification for Diseases (ICD) codes; Medi-cal , Medicare and insurance billing knowledge or experience; insurance claim forms: paper or electronic.
- Minimum of six (6) months of billing and customer service experience required.
- Ability to operate a computer and basic office equipment (calculator, copy machine).Must be proficient in Microsoft Work/Excel.
- Ability to communicate professionally in writing and orally and must be able to read and understand oral and written instructions.
- Data entry and clerical skills (typing, filing) accurate spelling and grammar is necessary.
- Must possess excellent customer service skills and maintain effective working relationship with patients; peers, managers and payers.
- Bilingual English/Spanish is highly desirable.
- Capable to analyze and solve problems with minimal supervision.
Business Intelligence Developer
Business Intelligence and Data Analytics
Camarillo
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
*Please note we are a H1 cap-exempt non-profit organization.
JOB OBJECTIVE
As a member of Data Management Group, the developer will provide the expertise in SQL Server BI Development and work with various data repositories. The developer will be working to develop full stack BI solutions which include implementing of data warehouse, ETL process, data analytics, predictive analysis/trends/patterns, data quality, data governance, interactive visualization, and dynamic reporting. The developer is responsible for leading the development of reporting and analytics solutions for Clinicas’s electronic health record (EHR) system by gathering business needs, documenting requirements, identifying appropriate data sources, and developing reports and dashboards.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Responsibilities:
The Data Warehouse/BI Developer II is responsible to perform all of, but not limited to, the following duties:
- Develops reports, self-service/interactive dashboards, and analytics packages using business intelligence suite of tools such as Tableau, SSAS, SSRS, SSIS, SSDT
- Calculates clinical metrics using healthcare data from various sources
- Extracts, integrates and processes data to support reporting of provider’s clinical performance, risks, outcomes, and population’s health
- Designs and automates data preparation and reporting programs
- Validates the integrity and accuracy of data
- Participates in project planning, report formats and statistical methodologies
- Investigates and evaluates alternative solutions to meet business needs
- Develops data models, architects and builds scalable/high availability data warehouse environments
- Supports the EMR, EPM, claim, and finance data warehouse
- Acts as an informed and thought partner with business users to analyze data to find answers to complex problems
- Acts as a liaison with end-users to collaborate on short and long term reporting requirements
- Determines project requirements for reporting activities and prepare project plans
- Translates requirements into repository and design; document all design specifications
- Assists in defining best practices and implementation standards for the data warehouse and across business intelligence and reporting delivery tools
- Independently and/or collaboratively develops solutions that are high performance
- Provides technical and administrative support of complex, enterprise-wide analytics systems to ensure data integrity and proper system functioning
- Adheres to and promotes best practices and standards work for all recurring activities.
- Mentors less experienced team members and business users on analytics principles and best practices
- Stays current on relevant industry developments – payment reform, regulations, quality measurement programs such as UDS, HEDIS, and Meaningful Use, performance improvement
Qualifications:
- 3+ years working experience in technical design of data analytics model such as SQL
- 3+ years working experience in developing ETL process and SQL programming skills
- 3+ years working experience in data warehouse environment performing implementation, integration and maintenance of online analytics platform.
- Proven hands-on technical experience with Microsoft Business Intelligence tools such as SSAS/SSIS/SSRS/SSDT and other visualization tools such as Tableau, QlikView, and power BI
- Understanding of database structures, theories, principles, and practices
- Understanding of ETL and data warehouse principles
- Working knowledge in T-SQL creating complex stored procedures and views
- Ability to translate business questions and requirements into reports, views, and BI query objects
- Experience in gathering, documenting, prioritize and tracking requirements
- Proven experience in standardizing process, setting up, supporting, and troubleshooting production systems
- An ability to be a self-motivated, high performance contributor
- Able to effectively work with ambiguity and incomplete information
- Ability to work with a minimal amount of direction while being pro-active in keeping their management informed of project related issues.
- Able to work well with people from all level within organization. Ability to respectfully question ideas and share a point of view with others in support of the business requirements and needs
- Ability to work well under pressure and adapt to changes in priority
- An excellent team player and willing to assist and train other team members to accomplish common goal
- Consistently demonstrate forward thinking.Strong aspiration to learn new technologies
- Possess strong interpersonal and written/verbal skills
- Consistently demonstrate excellent analytical, mathematical and problem solving skills
Additional Considerations:
- Working knowledge of various BI and visualization tools is a plus (Tableau, MicroStrategy, WebFocus, DataStage, Informatica etc.)
- Other programing language (.NET, C#, PowerShell, XML, Python) a plus
- Knowledgeable in predictive analytics (using SAS, R, or SPSS) a plus
Required education:
- A bachelor's degree in Computer Science or closely related field is required
Job Posting created: March 27, 2020.
Dental Back Office
Dental
Camarillo, Moorpark, Newbury Park, Oxnard, Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Looking for Dental Assistant or Registered Dental Assistant
The Dental Assistant provides support and assistance to our Dentists in providing quality care to our patients. Utilizes knowledge of dental instruments, equipment, and materials. Mixes amalgam and prepares dental accessories for patient visits. Communicates effectively with patients of all ages; provides information and instructions, as well as ease and comfort during appointments. Documents patient visit information utilizing electronic dental records system.
Must have a Dental Assistant certificate. Knowledge of and experience with common dental instruments, equipment, materials, names of the teeth and various surfaces of the crown of the tooth. Will excercise knowledge of principles and methods of sterilization, prophylaxis and dental hygiene. Ability to communicate effectively at a level required for successful job performance. Proficiency with use of computers and MS Word. Bilingual English/Spanish required.
Facility Maintenance Coordinator
Maintenance
Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Under the direct supervision of the Senior Facility Maintenance Coordinator, the Facility Maintenance Coordinator will perform a variety of maintenance functions.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Conducts daily mail runs for clinics. Responsible for the assembly, placement and storage of all office furnishings and equipment, including wall hangings. Responsible for basic repairs and upkeep of the plumbing and electrical fixtures such as, unclogging toilets and drains; installs/replaces light fixtures and fuses; makes minor repairs; paint touch-ups of exterior/interior walls and is responsible for maintaining corporate vehicles.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
Usual education and experience needed for satisfactory performance is high school graduation and one year of work related experience.
Health Education Outreach Specialists
Health Education
Simi Valley - East, Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Under the general supervision of the Outreach Coordinator, Health Center Manager, and oversight of the Director of Health Education and Prevention Programs, the Health Educator Outreach Specialist performs a variety of registration and financial screening functions with the objective of determining eligibility for medical care coverage under the terms of various private and public health care and financial services assistance programs. This position will be primarily entail evening and weekend work out in the community. The Enrollment Specialist is responsible for performing the following duties: • Researches and verifies patient eligibility for different programs and insurance coverage • Registers and interviews patients to obtain accurate and complete demographic and financial information. • Informs patients about the availability of governmental funded and discount programs. • Properly completes enrollment applications through electronic and manual systems. • Provides case management services for individuals and families on public and private health insurance programs. • Provides excellent customer service to patients, vendors and employees. • Must have reliable transportation to be used during working hours for off-site appointments and outreach activities.
- High school diploma or GED Certificate required.
- Must have at minimum two years’ clerical experience.
- Must be bilingual, English/Spanish.
- Must become a Certified Application Counselor under Covered California.
- Experience in a medical setting providing health education to patients is preferred.
- Must possess excellent verbal and written communication skills, strong grammar and spelling with a high degree of accuracy.
- Proficiency with use of computers is required, as well as a proficient level of typing.
- Must be flexible with work schedule and be available to work weekends and evenings.
- Must have reliable transportation.
- Must have and maintain a valid driver’s license.
Health Educator
Health Education, Medical
Ojai, Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
The Health Educator I will be under the general direction of the Health Education Coordinator designing, developing, and implementing Health Education programs and materials for the community clinic. Responsible for developing and implementing a marketing program to promote the organization’s services. Compiles and prepares monthly and quarterly reports to various funding programs. Assists in the in-house training of staff updating education programs and teaching skills. Assists in the in-house training of staff updating education programs and teaching skills.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Researches plans, develops and implements health education programs using existing staff and other community resources; assists in the development of pamphlets, flyers, publicity, and other education materials for community clinic patients; provides feedback to Health Education Coordinator for planning of patient programs to meet organization’s goals and objectives; develops and implements a marketing program to increase awareness of organization’s services; serves as advisor and assists program staff in developing pre-testing, and utilizing patient health education materials connected with specific programs; participates in recruiting and training outreach staff; other duties as assigned by the Health Education Coordinator.
Health Educator I: Bachelor’s Degree in Health Education and one year experience in areas defined. Health Educator II: Bachelor’s Degree and two years experience as a Health Educator or a Masters Degree from an accredited school in the public health field and one year experience in coordinating and supervising health education staff. Must be bi-lingual English/Spanish.
KNOWLEDGE AND ABILITIES
Knowledge and planning and developing health education programs; general health guidelines; research methodology; marketing techniques and knowledge of education programs for prenatal/postnatal high risk patients and infant care. Ability to conduct need assessment of rural communities; function effectively as a health care team member; interpret goals and objectives; identify and network with community resources of rural Ventura County; participate in developing health education policy and procedures; collaborate with Federal, State, County and community organizations concerning the need for quality patient health education programs and resources.
Healthcare Greeter
Medical
Ventura County
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Under the supervision of the Health Center Manager, the Healthcare Greeter (Greeter) will welcome and screen patients, employees and visitors at entrances to their assigned health center. They will provide direction and general information to individuals entering the building.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
The Greeter will be responsible for performing some or all of the following duties:
- Stationed outside of the health center, the Greeter will provide a positive first impression to patients, employees, and visitors by displaying excellent customer service
- Interact in a professional manner and work collaboratively with Clinicas’ staff and patients
- Follow approved script asking individuals entering the facility questions to protect against COVID-19 exposure. The screening process will also include checking temperatures
- Must be able to wear Personal Protective Equipment (PPE) at times when required.
- Performs other duties as assigned including participation in all safety programs, which may include assignment to an emergency response team
EDUCATION, EXPERIENCE AND QUALIFICATIONS
- High school diploma or equivalent required.
- Must have one year of clerical and/or customer service experience, preferably in a medical, dental, optometry or mental health office.
- Medical Assistant Certification preferred.
- Bilingual English/Spanish required. Must communicate professionally and effectively.
- Ability and desire to provide excellent customer service required.
- Must have reliable transportation, as may be required to rotate to other Health Centers as needed.
Information Systems Technician
Information Systems
Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Clinicas del Camino Real, Inc. in Ventura, CA is currently seeking an Information Systems Technician to help support the growing organization. This person will assist providing end user support and provisioning, installation, configuration, maintenance of systems hardware and application software. The IS Technician will be responsible to: • Monitor computers and networks • Respond to IS help desk requests and provide phone support • Generate and distribute reports • Assist in the setup of hardware, operation and applications software systems • Assist in providing enabling technologies for employees • Assist in providing training for all IT users • Perform other IS related duties as assigned
Requirements: • Associates degree in a computer related field or an equivalent of 5 years of experience. • Minimum two years of experience in IT field support. • Hands-on experience with Microsoft Windows 7 and Windows related applications. • Required certifications to include A+, NET+ • Physical Requirement: Ability to lift and carry up to 50 pounds. • Must be flexible with work schedule and have reliable transportation
Marketing and Communications Manager
Administration
Camarillo
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Under the general supervision of the Chief Business Development Officer, the Marketing and Communications Manager will be responsible to plan, direct, coordinate, develop and evaluate the organization's marketing strategies.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
The Marketing and Communications Manager is responsible for performing the following duties:
- Plan promotional campaigns and negotiate advertising contracts with various media outlets to build brand awareness.
- Identify target audience, including new and potential clients and members; develops a communication strategy and appropriate messaging for reaching target audience.
- Through public-facing communication, develops and maintains a positive public image for the organization.
- Develops and implements a long-term plan to communicate the Clinicas’ mission internally and externally.
- Composes, reviews, and/or distributes press releases and other public-facing communication.
- Promotes community events involving the company.
- Drafts and distributes materials to promote Clinicas’ services.
- Ensures compliance with applicable laws, regulations, or guidelines related to advertisements and messaging.
- May supervise supporting staff.
- Perform other duties as assigned including participation in all safety programs that may include assignment to an emergency response team.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
- Bachelor’s degree in Public Relations, Communications, Journalism, Marketing, or related field required.
- 3-5 years of experience in public relations, communications, or related field required with supervisory experience preferred.
- Excellent written communication skills with a proven ability to write in a journalistic style that is customary for external publications.
- Excellent interpersonal and networking skills with the ability to build and maintain relationships with media contacts and outlets.
- Excellent organizational skills and attention to detail.
- Excellent time management skills with a proven ability to meet deadlines.
- Proficient with Microsoft Office Suite, graphic design or related software.
- Team player with a strong work ethic
Medical Assistant
Medical
Oxnard, Simi Valley - Madera
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
The Medical Assistant I, II, III (MA) performs clinical and administrative duties in support of medical Providers. Interprets Providers’ orders in terms understandable to patients of varied educational and cultural backgrounds. Interacts with a multi-cultural population of diverse socioeconomic backgrounds and ages. Reports to the Health Center Manager and works under the direct supervision of medical professional staff, Lead Nurse, Lead LVN or Lead Medical Assistant
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
The Medical Assistant is responsible for performing the following duties:
- Interviews patients to obtain medical information and measures their vital signs.
- Escorts patients to exam rooms and prepares for the medical provider.
- Documents patients’ medical history, vital statistics and information such as test results in the electronic health records (EHR) system.
- Collects blood, tissue or other laboratory specimens as requested by medical provider and prepares them for testing.
- Prepares and administers medications as directed by medical provider.
- Translates and explains treatment procedures, medications, diets and medical provider’s instructions to patients.
- Performs blood draws, administers immunizations and injections.
- Prepares treatment rooms for patient examinations, keeping the rooms neat, clean and fully stocked.
- Cleans and sterilizes instruments and disposes of any contaminated supplies.
- Changes dressings on wounds.
- Contacts medical facilities or departments to schedule patients’ tests and/or admissions (on as-needed basis).
- Performs general office duties such as answering phones and completing forms when necessary.
- Takes inventory and orders medical, lab and office supplies and equipment.
- Maintains logs for recall purposes.
- Performs routine laboratory tests and performs daily testing controls.
- Operates electrocardiogram (EKG), and other equipment to administer routine diagnostic tests.
- Adheres to and follows universal precautions.
- Adheres to and follows established nursing policies, procedures and practices.
- Rotates to other Health Centers as needed.
- Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
- Provides excellent customer service to patients, vendors and employees.
- May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
- Due to the nature of the job, may work with or be exposed to information or material of a sexual nature.
- Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.
Must have received formal training and be certified as a Medical Assistant from an accredited school. Formal training and certification may be substituted with 1-2 years of work experience. Must have completed phlebotomy coursework, be able to draw blood and administer immunizations and injections. Phlebotomy certificate is desirable. Current CPR certification is required. Proficiency with use of computers and programs is required. Bilingual in English and Spanish is required. Must have the ability to establish effective relationships with patients and fellow staff; be a team player, self-motivated and detail oriented. Must have reliable transportation, as may be required to rotate to other Health Centers as needed.
Operations Manager
Administration, Operations
Camarillo
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
The Operations Manager reports to the Chief Operations Officer and will be responsible for overseeing the day-to-day management and operation of satellite clinic(s). The Operations Manager will implement the policies and procedures of the organization and work towards enhancing the development of clinic practices. Select, train, and supervise Health Center managers and employees. Assist in budget development and act as a liaison with local funding sources. Provide public relations representation at community functions and assist in the development and maintaining of corporate goals.
Bachelor’s degree, preferably in Business or Public Administration with at least two years of supervisory and management experience. Must have a thorough knowledge of business administration; supervisory, staffing and interviewing techniques and the ability to communicate effectively, both orally and in writing. Experience working with community organizations is desirable. Bilingual English/Spanish is highly desirable.
Optometric Technician
Medical, Optometry
Simi Valley - Madera, Ventura
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
The Optometry Technician supports and provides assistance to the Optometrist. The OT works under the supervision of the Optometrist and reports to the Health Center Manager. The OT performs pre-testing for patient and assists the Optometrist with examinations. Provides education to patients related to their frames and lens options in terms understandable to patients of varied educational and cultural backgrounds. Works with multi-cultural population of diverse socioeconomic backgrounds and ages. Under the direct supervision of the Optometrist, the OT may perform the following duties: Reviews patient history in Electronic Health Records system and updates medications, family history, personal medical and ocular history, tobacco use, etc. Prepares patient for examination. explains the examination process and administers tests to determine the visual capabilities of the patient. Documents notes during an examination.
High school diploma or equivalent is required. Certificate from approved Optometric Technician program or a minimum of one year of experience as a Patient Services Representative in the Optometry department in lieu of formal education/training. Proficiency with the use of computers and basic programs is required. Bilingual English/Spanish is required. Must be a team player, self-motivated and detail oriented. Must have reliable transportation, as may be required to rotate to other Health Centers as needed.
Patient Services Representative
Medical
Camarillo, La Colonia, Newbury Park, Ocean View, Oxnard, Simi Valley - Madera, Simi Valley - East
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
The Patient Services Representative (PSR) works under the supervision of the Health Center Manager. The PSR is the first point of contact for our patients and some of the duties include: • Greeting patients upon arrival and assisting them through the registration process. • Receives payments. • Completes patient’s intake forms and determines eligibility for patients’ ability to pay or their qualification in assistance programs. • Schedules and confirms appointments and works closely with the back-office to ensure an efficient and pleasant visit for our patients.
• Must have a high school diploma or equivalent. • One year of experience working as a front desk receptionist in a medical setting. • Experience working with electronic health records and knowledge of Medi-Cal and insurance billing is highly desirable. • Must be bi-lingual English/Spanish. • The ideal candidate will embody strong customer service and have a sincere desire to provide the utmost professional service and care to our diverse patient population.
Quality Improvement Manager
Administration, Medical
Camarillo
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Under the supervision of the Chief Medical Officer, the Quality Improvement Manager will be responsible to oversee and direct a quality improvement program. This will include analyzing data, fulfilling documentation and reporting requirements. In addition, the QI Manager will develop educational and informational materials, promoting health issues and providing internal and external customer support. The QI Manager will develop and maintain a system for outcomes measurement and reporting to determine whether the organization is achieving its quality goals.
ESSENTIAL FUNCTIONS AND RESPONSIBLITIES
The QI Manager will oversee and monitor the development and implementation of the quality improvement program, in collaboration with the Chief Medical Officer, Chief Operations Officer, Compliance Officer and other staff. The QI Manager will:
- Establish performance improvement targets for quality, service, and efficiency.
- Implement systems to ensure that services conform to regulatory requirements, contractual obligations, and Clinicas policy.
- Design and conduct surveys to assess the achievements of Clinicas and provide feedback to the program.
- Work with Operations and Compliance to conduct quality control audits, ensuring that processes and documentation are compliant with required standards and, implement follow up actions.
- Investigate, monitor, document and report on quality of care and service.
- Recommend changes for quality improvement in clinical Policies and Procedures and Protocols based on updated findings and information.
- Assure that improvement activities are documented and reported within the organization to engage staff in continuous quality improvement.
- Assess quality improvement training needs; plans and implements training for support staff
- Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
- Bachelor’s degree in a related field required; Masters preferred.
- Knowledge of QI processes, strategic planning and health services research, design and implementation.
- Minimum three years of clinical work experience in a health care setting including experience managing a quality improvement program.
- Proven ability to achieve results.
- Ability to communicate clearly, both verbally and in writing, with a diverse group of staff. Strong analytical reasoning and ability to interpret and evaluate complex information.
Referral Coordinator
Referral Center
Camarillo
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
Duties:
The Referral Coordinator is essential in obtaining medically appropriate services inside and outside of Clinicas del Camino Real, Inc. Patient needs, including referral to a Specialist, are identified by the Clinicas practitioner and processes through an established referral system. The Referral Coordinator is responsible for expediting the administrative requirements for the patient referrals for Clinicas Health Centers, ensuring that appropriate referrals are made to participating providers within the patients’ health plan, obtaining appointments for Specialist visits, and notifying the patient/member of the appointment. The Referral Coordinator acts as a resource regarding referrals and insurance plans guidelines. Work situations require an ability to interpret medical guidelines, benefits, policies, and procedures in support of their objective to expedite the referral process. Interacts with a multi-cultural population of diverse socioeconomic backgrounds, levels of education and ages.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
- Knowledgeable about the regulations of various payer sources including, but not limited to: Self Pay, Private Insurance, Medi-Cal, Medicare, Medi-Cal & Insurance Managed Care/HMO, Children’s Health and Disability Prevention (CHDP), Healthy Families, Family PACT, and California Children’s Services (CCS). Knowledgeable about the regulations regarding these various payer sources.
- Manages member/patient and provider inquiries regarding referral status, the authorization process and other issues in a courteous and professional manner.
- Data entry of authorization into Electronic Health Records and /or Utilization Review system, ensuring that all referrals are tracked through to a completed visit and a report is received.
- Collaborates with Providers, Health Center Nurses/Medical Assistants, and UM Nurses to obtain additional medical information and notifies UM Nurse of potentially urgent requests.
- Processes all referral requests according to Clinicas’ policies and procedures.
- Verifies member eligibility via insurance carrier and/or Medi-Cal web portal
- Participates in the introduction and implementation of new procedures.
- Makes recommendations regarding changes, improvements, or enhancements to appropriate staff.
- Assists with training and orienting new employees, as assigned.
- Coordinates and assists with obtaining surgery appointments and re-scheduling missed appointments as needed.
- Notifies patients of authorization status, as needed.
- Distributes denial letters to appropriate recipients.
- Attends meetings as assigned.
- Provides excellent customer service to patients, vendors and employees.
- May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
- Due to the nature of the job, may work with or be exposed to information or material of a sexual nature.
- Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.
Requirements:
- High school diploma or GED required; AS degree and/or Medical Assistant Certificate or Medical Billing Certificate preferred.
- Cognitive Skills (Language, Math and Reasoning Ability): High reasoning, high language skills including medical terminology, critical thinking and critical problem solving skills required. Bilingual English/Spanish speaking and writing is required.
- Ability to work in a team environment is required.
- Excellent organizational skills are required.
- Prefer 2 years’ work experience in a medical environment (IPA or HMO preferred), with pre-authorizations and reimbursement.
- Familiar with regulations pertaining to various payer sources.
- Computer Skills: Ability to effectively use Word, Excel, access specific sites on the internet, document within electronic health records and/or authorization system with minimal typing/spelling errors, send e-faxes and email.
- Ability to work with a diverse group of people; handle multiple issues that are time sensitive and to ask appropriate questions.
- Must have reliable transportation to work.