Duties:

Duties:

Under the supervision of the Chief Financial Officer, the Administrative Assistant will perform a variety of office and administrative functions.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Receives and screens requests of persons wishing appointments with management; schedules and maintains calendar of appointments; screens callers, both in person and by telephone to determine the nature of question; handles routine inquiries independently; types a wide variety of internal/external correspondence, reports, proposals, etc.; attends regularly scheduled monthly meetings, prepares agenda and corresponding minutes; composes/drafts routing correspondence as required; develops and maintains administrative files, assists as requested in the preparation of departmental projects, procedures and the implementation thereof; opens and routes incoming mail and email; delivers and picks up mail on assigned times of the day. May handle projects or coordinate projects and maintain reports for routine reporting; tracks expenses and prepares reports regarding such expenses. 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 graduate. Ability to type accurately at the rate of 65 w.p.m. Computer proficient including thorough knowledge of Microsoft Office Suite including Word, Power Point, Excel and Outlook. Ability to draft professional correspondence, excellent spelling, grammar and punctuation. .Bilingual in English and Spanish preferred.

Levels I & II: Two years of increasingly responsible administrative experience.

Levels III & IV: Five years of increasingly responsible administrative experience.

DISTINGUISHING CHARACTERISTICS

This class functions as a key assistant to a member of management handling confidential and sensitive matters of an administrative nature. Successful functioning is dependent upon good rapport and close working relationship with department heads.

PHYSICAL DEMANDS

Work is performed in a professional setting. Working extended hours may be required as needed. Extended periods of sitting and or standing, telephone work and/or computer work, as well as interactions with other staff members. Ability to lift and transport files; less than 20 pounds. The noise level in the work environment is usually moderate.

Duties:

The Benefit Specialist puts into practice knowledge of human resources principles, as well as state and federal employment law in the day-to-day execution of benefit administration.  Administers the company’s employee healthcare benefit, retirement and pension plans. The Benefits Specialist reports to the Human Resources Manager. 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Benefit Specialists is responsible for performing the following duties: 

• Distributes benefit enrollment materials and determines eligibility. 
• Conducts Benefit Orientation for new hires and employees with changes in status. Processes all company benefit enrollments and changes. 
• Sends communication regarding health insurance and retirement plans when there are changes or legally required notices
• Coordinates annual open enrollment sessions along with HR Manager. 
• Coordinates and takes minutes for Insurance trust meetings. 
• Processes retirement plan enrollments, plan loans and distributions for Clinicas and its subsidiaries. 
• Responds to benefit verification requests. 
• Creates and processes personnel action forms.  
• Processes life insurance enrollment, changes and age band increases. Assists employees’ beneficiaries with claims processing when needed. 
• Responds to benefits and retirement plan inquiries from managers and employees on plan provisions, benefits enrollments, status changes and other general inquiries. 
• Collaborates with Payroll, Leave Specialist and third-party administrators on billing and collection of premiums. 
• Organizes plan documents and requested files for benefit and retirement plan audits. 
• Processes annual ACA reporting in collaboration with Leave Specialist. 
• Provides support to the Leave Specialist, as needed and in their absence. 
• Answers questions related to personnel policies and procedures.
• Prepares reports as needed.
• May assist with the coordination of employee relations functions. 
• Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

JOB OBJECTIVE

Under the general supervision of the Medical Director or Nurse Manager, the Clinical Agent will be provide nursing care to patients by way of limited patient assessment via telephone, assisting with appointment coordination, and collaboration with others within and outside the organization. Primary objective is to engage with patients and improve coordination of care. 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Clinical Agent is responsible for performing the following duties:

• Monitors and responds to patient inquiry calls.
• Assists with the evaluation and assessment of patient's health care needs based on patient's signs and symptoms utilizing established triage protocols and guidelines. 
• Effectively and efficiently uses clinical decision-making tools and algorithms.
• Reports accurate medical information to assist provider with decision making.
• Appropriately identifies patients with urgent needs and triages them with a provider to refer either to the emergency department or urgent care for evaluation.
• Provides appropriate health advice within the scope of their licensure/certification to patients who do not require immediate in person care with a provider.
•  Documents accurate notes of all conversations and patient interactions in the patient’s EMR.
• Patient Education: Offer educational resources and information to patients.
• Collaboration: Work with other healthcare professionals to ensure comprehensive patient care.
• Schedules appointments for patients who need to see a CDCR provider, consulting with providers as appropriate.
• Assists with supporting patients with medication questions i.e. frequency processing refill requests as dictated by prescribing provider.
• Serve as a clinical resource and professional role model for other staff.
• Communicates appropriately and tactfully with staff, consultants, patients and their families, and the community.
• Provides a timely response to inquiries, which may take place via telephone or alternative communication platforms such as text messaging.
• Participates in staff, training, and other meetings as needed. May be responsible for development of training materials or policies & procedures. Performs other duties as assigned, including scheduling and outreach calls.

Duties:

JOB OBJECTIVE

Under the general supervision of the Health Education Outreach Coordinator and oversight from the Director of Health Education and Prevention Programs, the Health Education Outreach Specialist (HEOS) performs a variety of community services: health education community classes, health screenings and linking community to health care services.  The HEOS will primarily work in the community with specific target populations to promote Clinicas’ services in agricultural fields, packing houses, food pantries, and other community organizations, primarily focused on the farmworker and migrant target population throughout Ventura County. The HEOS interacts with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The HEOS is responsible for performing the following duties:

• Researches and verifies patient eligibility for different medical programs. 
• Registers and interviews patients to obtain accurate and complete demographic information.
• Informs patients about the availability of governmental funded and discount programs.
• Recruits new patients for CDCR and schedules appointments.
• Conducts community presentations and health screenings.
• Serves as an interpreter between provider and patient as needed.
• Conducts education at the appropriate level in a variety of areas including but not limited to preventative care, prenatal care, reproductive health, nutrition, chronic diseases, oral health and pediatrics.
• Utilizes a variety of resources to provide education including Department curricula, written educational materials, brochures, posters, models and videos.
• Conducts maternity tours at the contracted hospitals for prenatal patients as needed.
• Provides patient advocacy including assistance with community referrals, disability & paid family leave forms, WIC, medication assistance and other advocacy services aiding as a liaison to connect patients to resources.
• Promotes services via in-person, broadcast & social media as requested.
• Documents encounters using electronic health records, HED data base and other applicable forms.
• Will be required to both capture and provide information that is of a sexual health nature which will involve family planning. 
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Performs other duties as assigned including participation in all safety programs, which may include assignment to an emergency response team.
• Must have and maintain a valid driver license.

KNOWLEDGE AND ABILITIES

• Ability to work individually as well as in group settings with minimal supervision.
• Work with people of different cultural, ethnic, and social-economic backgrounds, particularly underserved populations and have a desire to help others improve their health.
• Must have dedication to team work and the ability to deliver exceptional patient service.
• Must have strong communication skills.
• Possesses excellent computer skills and have basic knowledge of computer programs (Word, Excel, Publisher, etc.).
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients. Provides excellent customer service to patients, vendors and employees.
• Possess strong desire to improve the health and well-being of target populations. Be a self-motivated, independent, innovative thinker and a resourceful problem solver.
• Must have a flexible work schedule and be available to work weekends and evenings as requested.
• Complete and maintain program certifications as assigned by supervisor.
• Must have reliable transportation to be used during working hours for off-site appointments and outreach activities. 

Duties: 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. 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. 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.

Duties:

The Lead Registered Dental Assistant (LRDA) supports and provides assistance to Dentists chair-side. Assists with set-up of equipment, prepares patient for treatment and assists during procedures. Provides first-line supervision for Dental Assistants. The LRDA works under the supervision of the Dentist and reports to the Health Center Manager. Interprets Dentist’s orders in terms understandable to patients of varied educational and cultural backgrounds. Works with a multi-cultural population of diverse socioeconomic backgrounds and ages.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Under the direct supervision of the Dentist the Lead RDA/RDAEF may perform the following duties:

• Provides direct dental care to patients and performs all duties of a Registered Dental Assistant.
• Documents patient visits utilizing electronic dental records.
• Provides supervision to Dental Assistants and Registered Dental Assistants to ensure patient care and procedures are followed consistently and correctly.
• Works with front desk staff to ensure optimal patient flow in the back office.
• Provides training to Dental Assistant staff.
• Assists Health Center Manager with corrective action, completion of performance evaluations and skills checklists.
• Orders and maintains inventory of dental supplies in lab and dental operatory.
• 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.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

The Leave Specialist puts into practice knowledge of human resources principles, as well as state and federal employment law in the day-to-day execution of Clinicas’ leave of absence and workers’ compensation program administration.  The Leave Specialist reports to the Employee Relations Manager. 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Leave Specialist is responsible for performing the following duties: 

• Administers leaves of absences practicing knowledge of state and federal laws. 
• Communicates with employees regarding their needs for leave and/or modified work schedules. Ensures that employees are aware of their responsibilities and of any documentation and notice required to qualify for and to take leave.
• Handles the FMLA leave administration process beginning from the employee’s initial notice of the need for leave, through their return to work: Gathers and completes all required paperwork; determines leave eligibility; designates leave as FMLA-qualifying when applicable; requests medical certification as needed. 
• Maintains reasonable communication with employees on leave to facilitate smooth and timely return to work; relays communication between employees and their managers during leave within reason.
• Advises managers and employees on the interaction of leave laws with paid time off, workers compensation, and short-term and long-term disability benefits.
• Oversees the return-to-work process for employees returning from extended FMLA, workers compensation, or other leave(s).
• Facilitates other leave requests, which may include accommodation requests under the ADA.
• Maintains complete and accurate records of leave and accommodation requests in accordance with specified legal requirements and documentation of best practices.
• Preserves confidentiality of employee medical documentation and files.
• Maintains knowledge of all applicable leave and accommodation laws including FMLA, ADA, and state and local laws.
• Responds to Disability and Paid Family Leave claims. 
• Administers employee COVID protocol: Conducts contact tracing; generates reports; collaborates with payroll; other related functions. 
• Administers Workers’ Compensation program: Reviews employee claim forms for completion and submits claims to WC carrier in a timely manner; Conducts follow up with injured employees, managers and claims examiners; Injury reporting – monthly and at Safety Committee meeting; Annual OSHA logs;  other related functions. 
• Provides support to the Benefit Specialist, as needed and in their absence. 
• Completes annual ACA reporting in collaboration with Benefit Specialist. 
• Answers questions related to personnel policies and procedures.
• Prepares reports as needed.
• May assist with the coordination of employee relations functions. 
• Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

The Licensed Vocational Nurse (LVN) provides nursing services to ambulatory care patients and in emergency settings when necessary. Performs skilled tasks and paraprofessional nursing duties requiring specialized training. The LVN reports to the Health Center Manager and works under the direct supervision of the Lead Licensed Vocational Nurse and Medical Provider when providing patient care. Interacts with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Licensed Vocational Nurse performs the following duties:

-         Provides nursing care to Health Center patients.

-         Conducts patient screenings and assist provider with triaging.

-         Physically and psychologically prepares patients for treatments, examinations, and scheduled diagnostic studies.

-         Instructs patients on proper use of medical equipment and teaches them skills to care for their particular medical needs.

-         Is responsible for recognizing and interpreting symptoms and reporting condition of patient to the attending physician.

-         Documents patient visits utilizing electronic health records system.

-         Keeps inventory of stock medicines available and makes weekly drug and medical supply orders. 

-         Administers treatment and medication under physician’s orders, except for intravenous medications.

-         Verifies and administers immunizations upon physician’s orders.

-         Prepares in-house monthly EHR reports.

-         May provide supervision of Medical Assistant personnel.

-         Coordinates patient flow activities and assists with patient records audit for their quality of care system.

-         Participates in Quality Improvement as necessary.

-         Adheres to and follows established nursing policies, procedures and practices.

-         May float to other Clinicas sites when additional coverage is 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.

Duties:

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.

Duties:

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.

Duties:

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.

Duties:

The Registered Dental Assistant (RDA) supports and provides assistance to Dentists chair-side. Assists with set-up of equipment, prepares patient for treatment and assists during procedures. The RDA works under the supervision of the Dentist and Lead Registered Dental Assistant and reports to the Health Center Manager. Interprets Dentist’s orders in terms understandable to patients of varied educational and cultural backgrounds. Works with a multi-cultural population of diverse socioeconomic backgrounds and ages.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Under the direct supervision of the Dentist or the Lead RDA, the RDA/RDAEF may perform the following duties:

• Sterilizes, prepares and arranges equipment and accessories.
• Keeps dental department and equipment neat, clean and sanitary.
• Utilizes common dental instruments, equipment and materials.
• Utilizes and understands dental terminology.
• Takes digital dental x-rays.
• Instructs patients in the proper practices of dental hygiene.
• Assists in the dental laboratory.
• Documents patient visits utilizing electronic dental records.
• Mixes amalgam.
• Takes impressions for diagnostic and opposing models.
• Removes sutures.
• Places and removes rubber dams.
• Places wedge and removes all matrices. Holds anterior matrices.
• Applies topical fluoride after scaling and polishing is provided by the supervising Dentist. 
• Applies sealant.
• Performs coronal polishing.
• Applies non-aerosol and non-caustic topical agents.
• Removes post-extraction and periodontal dressings.
• Assists in the administration of gases; does not adjust the flow of the gases unless instructed to do so by Dentist, who shall be present at the patient’s chair-side at the implementation of these instructions. This regulation shall not be construed to prevent any person from taking appropriate action in the event of a medical emergency.
• Assists with orthodontic procedures such as placing and removing elastic orthodontic separators, taking intra-oral measurements for orthodontic procedures, seating adjusted retainers or headgears, checking for loose bands, removing arch wires and ligature ties.
• 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.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Functions specific to RDA Extended Functions: (These duties are to be performed under direct supervision of a licensed Dentist. Procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient.)

• Cord retraction of gingivae for impression procedures
• Takes impression for cast restorations, space maintainers, orthodontic appliances and occlusal guards.
• Prepares enamel by etching for bonding
• Formulates indirect patterns for endodontic post and core castings
• Fits trial endodontic filling points
• Applies pit and fissure sealants
• Removes excess cement from subgingival tooth surfaces with a hand instrument
• Applies etchant for bonding of restorative materials

Duties:

JOB OBJECTIVE

The Information Systems Administrator (ISA) reports directly to and is under the direct supervision of the IS Manager. The ISA will administer and support client workstation and server systems hardware, operating systems and applications software. The ISA will align with the IT objectives towards the delivery of effective IT solutions, systems security, reliability and performance. The ISA will adhere to and promote compliance with the organization’s information systems policies and procedures. The ISA will rely on instructions and established guidelines to perform the functions of the position.

ESSENTIAL FUNCTIONS AND RESPONSIBLITIES

Administer and support workstation and server hardware, server operating system software, application and office productivity software and network resources; administer data backup; troubleshoot and recover workstation, server and network functionality; support patient processing, clinical tracking and reporting activities; ensure proper and timely communication and resolution of systems issues; train employees on systems use, proper access to corporate network and available resources, use of office software tools and use of business software; other systems administration and support tasks as assigned. Additional duties may also include participation in all safety programs which may include assignment to an emergency response team.

Duties:

JOB OBJECTIVE

Total Rewards Manager reports directly to and is under the direct supervision of the Chief Human Resource Officer. The Total Rewards Manager, designs, implements, and manages comprehensive rewards packages, encompassing compensation, benefits, and incentive programs, to attract, retain, and engage talent, while aligning with organizational goals. 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Total Rewards Strategy:

• Develop and implement a comprehensive total rewards strategy that aligns with the organization's business objectives and talent needs.
• Develop and manage total rewards policies and procedures. Ensure policies are in alignment with organization goals and strategies.

     Compensation Management:

• Conduct market research and benchmarking to ensure competitive compensation structures. 
• Develop and maintain salary structures, job evaluation systems, and performance-based compensation programs. 
• Manage the annual salary administration process, including merit increases, promotions, and bonuses. 
• Provide guidance and recommendations on compensation matters to HR and managers. 
• Facilitate the compensation committee to ensure organizational support and input on effective and competitive compensation strategies. 
• Takes the lead in managing compensation software programs (salary.com)
• Participate in contributing data to compensation benchmarking programs such as California Primary Cara Association (CPCA), Salary.Com and MGMA. 
• Supports Talen Acquisition Team in compensation offers.                                                                                                                                               

Benefits Administration:

• In collaboration with the Clinicas Benefits Trust, Design, implement, and administer employee benefits programs, including health, dental, vision, life, and long-term disability insurance and voluntary insurance plans.
• Manage benefits enrollment, communication, and vendor relationships. 
• Monitors administrators’ and insurance carriers’ reports to ensure the organization’s compliance with plan requirements.
• Ensures the organization’s and plans’ compliance with the applicable provisions of COBRA, HIPAA, and ERISA.

Incentive programs

• Develop, manage and administer organizational incentive programs in collaboration with finance and members of the executive team to enhance employee engagement and motivation.

Data Analysis and Reporting:

• Analyze compensation and benefits data to identify trends and areas for improvement.
• Prepare reports and presentations to communicate key findings and recommendations. 

Communication and Education:

• Develop and deliver a comprehensive total rewards communication and education plan. 
• Collaborate and communicate with key stakeholders to ensure smooth implementation of compensation programs.

   Legal Compliance:

• Ensure that all total rewards programs meet legal compliance requirements and audits regularly and accordingly.

    Budget Management:

• Responsible for the annual preparation of the total rewards budget as well as continual monitoring and re-forecasting throughout the year. 

Team Management

• Manages members of the total rewards team including Leave and Benefits Specialist. 
• Operates as one of the HR Leadership team members.

Employee Safety and Leave Management

• Provides oversite of all leave management processes and programs.
• Provides oversite of worker’s comp, ergonomic and ADA programs. 
• Performs other duties as assigned to support HR Department.

Duties:

Under the general supervision of the UM/QI Director, the UM Coordinator is responsible for processing phone, fax, and electronic authorization requests for medical services from physicians and hospitals (providers) in an efficient, accurate and customer-focused manner.  This position will also assist healthcare providers in ensuring compliance as established by program guidelines.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Effectively handles authorization requests and inquiry phone calls from providers, balancing excellent customer service with efficiency and established turn-around times.  Follows appropriate procedures for checking member eligibility, authorization history, and the status of provider participation within the contracted network.  Based on the information provided by the provider and gathered from computer systems, determines the appropriate handling of each request.  Utilizing accepted protocol, determines authorization requirements based on the type of service requested, the location of the service, and the provider specifics.  Inputs review data into systems with minimal errors.  Based on authorization rules and urgency, either approves the authorization request, or sends the nurse for review.  Communicates authorization specifics to providers and members either verbally through phone calls or written through fax or mailed letters.  Interprets a variety of instructions furnished in written and oral forms.  Assists in preparing and submitting projects, reports or assignments as needed to meet department initiatives and/or objectives.  Assumes responsibility for professional development of self and assists with training other staff members to contribute to their professional development.  Attend meetings as assigned.  Meet with staff at various health centers as assigned.

Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

The UM Nurse’s responsibilities include, but are not limited to:

      Level 1 - LVN:

• Conduct clinical review for service requests for medical appropriateness and medical necessity using clinical judgment, independent analysis, and knowledge of medical policies, clinical guidelines, and benefit plans
• Review, triage, and prioritize authorization requests to meet required turn-around times.
• Expedite access to appropriate care for members with urgent or immediate needs using the expedited review process.
• Research member issues and assess member needs related to authorization requests.
• Acquire appropriate clinical records, clinical guidelines, policies, EOC and benefit policy. Accurately applies coding guidelines.
• Develop determination recommendations and present cases to Medical Director (or designee) for potential denial determinations or when Medical Director input is needed.
• Interact with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements.
• Develop and/or review appropriate documentation and correspondence to member and providers reflecting determination. Ensure documentation is accurate, complete and conforms to established regulatory standards.
• Document all activities as per department practice including entry into automated systems. Recognizes potential quality of care concerns and refers as appropriate.
• Make appropriate referrals to California Children’s Services (CCS) and Tri-Counties Regional Center (TCRC).
• Identify and refer members who may benefit from care coordination programs, such as disease management or case management, and make appropriate referrals.                                             
• Attend meetings or meet with staff within the organization as assigned.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

LEVEL 2 - RN: (in addition to above)

• Conduct clinical review for service requests for medical appropriateness and medical necessity using considerable clinical judgment, independent analysis, critical-thinking skills, and detailed knowledge of medical policies, clinical guidelines, and benefit plans.
• Utilizes strong critical thinking skills for complex clinical reviews and care coordination.
• Ensures that assigned health plans are meeting or exceeding Medicare/Medicaid/Commercial  performance benchmarks per health plan contracts.
• Builds and maintains relationships with internal and external clinical teams to help resolve barriers to referrals and care.
• Acts as a clinical resource to LVN staff. 
• Begins to influence department's strategy and provide constructive feedback to Medical Management leadership.
• Makes decisions on moderately complex to complex issues regarding technical approach for project components, such as Medical Management system enhancements, and work is performed with minimal direction.

Duties:

The UM Nurse’s responsibilities include, but are not limited to:

      Level 1 - LVN:

• Conduct clinical review for service requests for medical appropriateness and medical necessity using clinical judgment, independent analysis, and knowledge of medical policies, clinical guidelines, and benefit plans
• Review, triage, and prioritize authorization requests to meet required turn-around times.
• Expedite access to appropriate care for members with urgent or immediate needs using the expedited review process.
• Research member issues and assess member needs related to authorization requests.
• Acquire appropriate clinical records, clinical guidelines, policies, EOC and benefit policy. Accurately applies coding guidelines.
• Develop determination recommendations and present cases to Medical Director (or designee) for potential denial determinations or when Medical Director input is needed.
• Interact with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements.
• Develop and/or review appropriate documentation and correspondence to member and providers reflecting determination. Ensure documentation is accurate, complete and conforms to established regulatory standards.
• Document all activities as per department practice including entry into automated systems. Recognizes potential quality of care concerns and refers as appropriate.
• Make appropriate referrals to California Children’s Services (CCS) and Tri-Counties Regional Center (TCRC).
• Identify and refer members who may benefit from care coordination programs, such as disease management or case management, and make appropriate referrals.                                             
• Attend meetings or meet with staff within the organization as assigned.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

LEVEL 2 - RN: (in addition to above)

• Conduct clinical review for service requests for medical appropriateness and medical necessity using considerable clinical judgment, independent analysis, critical-thinking skills, and detailed knowledge of medical policies, clinical guidelines, and benefit plans.
• Utilizes strong critical thinking skills for complex clinical reviews and care coordination.
• Ensures that assigned health plans are meeting or exceeding Medicare/Medicaid/Commercial  performance benchmarks per health plan contracts.
• Builds and maintains relationships with internal and external clinical teams to help resolve barriers to referrals and care.
• Acts as a clinical resource to LVN staff. 
• Begins to influence department's strategy and provide constructive feedback to Medical Management leadership.
• Makes decisions on moderately complex to complex issues regarding technical approach for project components, such as Medical Management system enhancements, and work is performed with minimal direction.

Duties:

The Urgent Care Licensed Vocational Nurse (LVN) performs clinical and administrative duties in support of medical clinicians in a fast paced Urgent Care environment providing care for urgent but non-life threatening conditions. Performs skilled tasks and paraprofessional nursing duties requiring specialized training. Interprets clinician’s orders in terms understandable to patients of varied educational and cultural backgrounds. Interacts with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education. The LVN reports to the Health Center Manager and works under the direct supervision of the Lead Licensed Vocational Nurse and Medical Clinician when providing patient care.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Licensed Vocational Nurse is responsible for performing the following duties:

• Escorts patients to exam rooms, measures their vital signs and prepares them for medical clinician.
• Triages patients to obtain medical information and assigns acuity level based on the standardized emergency severity index.
• Is responsible for recognizing and interpreting symptoms and reporting condition of patient to the attending physician.
• Administers treatment and medication under medical clinician’s orders, including intravenous medications.
• Assists providers during examinations and procedures, including but not limited to splinting, casting, sutures and skin lesion removals, and minor surgeries, among others.
• Administer routine immunizations, therapeutic, intramuscular and subcutaneous injections and skin tests upon clinician’s orders.
• Completes Clinical Laboratory Improvement Amendments (CLIA) approved waived laboratory tests and practice-specific diagnostic testing; including Point of Care testing for Hemoglobin A1C and other Point of Care testing as applicable. Adheres to CLIA standards.
• Instructs patients on proper use of medical equipment and teaches them skills to care for their particular medical needs.
• Establishes IV lines and monitors IV therapy of standard solutions.
• Removes sutures and performs dressing changes
• Collects blood, urine, tissue or other laboratory specimens as requested by medical clinician and prepares them for testing.
• Prepares patients for x-rays.
• Documents patients’ medical history, vital statistics and information such as test results in the electronic health records (EHR) system.
• May assist in keeping inventory of stock medicines and asked to place weekly drug and medical supply orders, under the supervision of the Lead Licensed Vocational Nurse. 
• Enters orders in EHR system per medical provider’s instructions.
• May assist in orienting or training new medical personnel or externs, under the supervision of the Lead Licensed Vocational Nurse. 
• Cleans and sterilizes instruments and disposes of any contaminated supplies.
• May assist with in-house monthly EHR reports, under the supervision of the Lead Licensed Vocational Nurse.
• May provide supervision of Medical Assistant personnel.
• Coordinates patient flow activities and assists with patient records audit for quality of care system.
• Participates in Quality Improvement as necessary.
• Successfully completes six-month and annual skills and competency checklist.
• Adheres to and follows established nursing policies, procedures and practices.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
• Maintains a neat and professional image.
• Maintains patient confidence and protects operations by keeping patient care information confidential in compliance with HIPAA regulations
• 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.

 

Duties:

The Urgent Care Medical Assistant (Medical Assistant) performs clinical and administrative duties in support of medical clinicians in a fast paced Urgent Care environment providing care for urgent, but non-life threatening conditions. Interprets clinician’s 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 and Lead Licensed Vocational Nurse.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Medical Assistant is responsible for performing the following duties:

• Escorts patients to exam rooms, measures their vital signs and prepares them for medical clinician.
• Documents patients’ medical history, vital signs and information such as test results in the electronic health records (EHR) system.
• Assists providers during examinations and procedures, including but not limited to splinting, sutures and skin lesion removals, among others.
• Collects blood, urine, tissue or other laboratory specimens as requested by medical clinician and prepares them for testing.
• Completes lab requisitions and prepares specimens for pick-up.
• Prepares and administers medications as directed by medical clinician.
• Translates and explains treatment procedures, medications, diets and medical clinician’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 other departments or external medical facilities 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.
• Successfully completes six-month and annual skills and competency checklist.
• Adheres to and follows established nursing policies, procedures and practices.
• Maintains a neat and professional image.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
• Maintains patient confidence and protects operations by keeping patient care information confidential in compliance with HIPAA regulations.
• 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.

Duties:

JOB OBJECTIVE

The Patient Services Representative (PSR) provides front office clerical and administrative support to the Health Center’s medical, dental, optometry and mental health departments. Works under the supervision of the Health Center Manager. Works with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The PSR may be responsible for performing some or all of the following duties:

• Provides excellent customer service to patients, vendors and employees
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients
• Works in a fast-paced environment and proactively analyze and resolve problems
• Assists patients with completion of intake forms
• Answers phones; documents telephone calls when applicable
• Determines if patient qualifies for sliding fee program; refers patients to enrollment specialist when necessary
• Verifies insurance eligibility; submits insurance authorization requests as required by insurances
• Receives and posts payments with correct payer code to patient accounts
• Collection of payment at time of service
• Scans documents into proper categories in patients’ electronic health record
• Schedules new and follow-up appointments; confirms next-day appointments
• Adheres to front desk policies and procedures
• Updates patient files utilizing Electronic Health Records
• Processes requests for Release of Records by reviewing, copying or typing special letters/summaries of records as indicated by Provider or Health Center Manager
• Reviews daily charges
• Works closely with back office staff to prioritize patients that need to be triaged
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance
• Performs other duties as assigned including participation in all safety programs, which may include assignment to an emergency response team

Duties:

JOB OBJECTIVE

Under the general direction and supervision of the Physician, the X-Ray Technologist (XRT) performs radiographic procedures at a technical level not requiring constant supervision. Utilizes independent judgment, ingenuity and initiative in application of prescribed ionizing radiation for radiological diagnosis. Interprets Physician’s 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.

 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The X-Ray Technologist is responsible for performing the following duties:

• Produces radiographs and provides immobilization devices as required.
• Provides protection in accordance with prescribed safety standards.
• Selects and operates equipment as directed.
• Selects proper technical factors on an individual patient basis according to Provider’s request.
• Is responsible for the delegated areas of authority in the performance of routine or specific procedures.
• Practices sterile techniques and prevents cross contamination.
• Assists in performing first aid when necessary.
• Documents patient visits and results in electronic health records system.
• Maintains organization and cleanliness of work area and equipment.
• Secures supplies and equipment.
• May assist in the development of technical factors.
• May assist in the use of a variety of equipment and procedures not routinely utilized.
• Interacts in a professional manner and works collaboratively 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.

Duties:

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Women’s Health Case Manager is responsible for performing the following duties:

• Informs patients about the availability of EWC services.
• Interviews patients to obtain accurate and complete demographic, financial and eligibility information.
• Researches and verifies patient diagnosis and eligibility for a variety of women’s programs including EWC-BCCTP coverage. 
• Properly completes EWC-BCCTP enrollment applications through electronic and manual systems.
• Clarifies professional/medical instructions to patients and provides supportive educational counseling to reinforce Provider instructions.
• Provides case management services for individuals on EWC-BCCTP, generates patient letters and bills encounters following program guidelines.   
• Utilizes data analytics systems to capture potential patients for education services and for case management purposes.
• Documents all patient encounters using electronic health record systems, scans documents into health record.  Compiles and prepares monthly report.
• Works with current department grants providing support to meet requirements.
• Conducts CDCR in-service activities which educate CDCR staff about EWC-BCCTP program protocols.
• Conducts outreach activities which include patient presentations on Women’s Wellness and health screenings within the health center and community setting. Promotes services via in-person, broadcast & social media as requested.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Will be required to both capture and provide information that is of a sexual health nature which will involve family planning.
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Will work individually as well as in group settings with minimal supervision
• Complete and maintain program certifications as assigned by supervisor.
• Will work extended hours and weekends as needed.
• Performs other duties as assigned, including participation in all safety programs, which may include assignment to an emergency response team.