Social Needs Project Specialist - Hybrid Nonprofit Role

Primary Work Location: Remote (Oregon Headquarters)This position is Local Hybrid with flexibility to work both remotely and/or in-person at YCCO's office in McMinnville and open only to candidates residing in the local McMinnville, OR Area.Department: Health Plan Operations FLSA Status: Exempt (Salaried)Division: Community Health Physical Strength: Light (L)Reports To: Community Health Systems & Tribal Relations ManagerWork Location Type: Local Hybrid Supervisory Role: No Occasional Weekend Work: YesAbout Us: Yamhill Community Care is a nonprofit coordinated care organization dedicated to managing the healthcare for Medicaid members, covered under the Oregon Health Plan, in Yamhill County, as well as parts of Washington and Polk Counties.Learn more about Yamhill Community Care: click hereSummaryThe Social Needs Project Specialist expands, maintains, and monitors capacity for social needs services and supports eligible Yamhill Community Care (YCCO) members, by working with various vendors, community-based organizations, and providers of targeted resources and services offering nutrition, housing, and other social supports. This position also works extensively with internal teams including Care Management (CM) and Utilization Management (UM). This position requires extensive knowledge of resources within the community and an understanding of barriers that impact individuals and families in YCCO communities, which may prevent them from accessing and/or obtaining the resources they need for stability.Essential DutiesDevelops strategies and policies for partnership with community and provider organizations to create a social needs provider network that can meet the social needs of all eligible members.Builds and maintains a consistent and reliable network of providers.Manages strong relationships with stakeholders in order to support coordination with internal CM program and staff and addresses barriers concerning benefit delivery.Manages collaborative projects within and across teams that may include, but is not limited to, other program Specialists, Community Health Workers (CHW), CM Case Managers, Nurse Case Managers, Community Providers, Health Supervisor, Traditional Health Worker Liaison.Designs and presents training materials and process documents offering guidance around social needs benefits, programs, and services.Job DutiesCommunity Resource DevelopmentInterprets Oregon Health Authority (OHA) contract and state and federal regulations, incentive metric requirements, Health Equity Plan, and other plan-related documents to maintain compliance with social needs benefit and service delivery requirements.Develops strategic engagement and relations plan for YCCO’s partnership with community-based organizations and local and state service providers and vendors.Develops and maintains policies and procedures regarding the provision of health-related services benefit and services and the social needs provider network.Manages the compilation and inventory of resources available throughout the YCCO region and surrounding counties to meet the health-related social needs of members, including food, housing, and climate supports.Develops and maintains cross-agency partnerships and relationships that will support YCCO’s social needs. Leads Community Information Exchange implementation and process improvement activities.Delivers OHA and internally required reports and documentation related to Heath Related Social Needs services resources and services.Provider Network ManagementRecruits, supports, and provides technical assistance for contracted social needs providers to maintain reporting and provider agreement compliance.Supports and maintains processes related to social needs requests through Community Information Exchange and Prior Authorization pathways.Manages conflicts, barriers, issues and/or concerns between vendors / service providers and members or CM staff.Develops new and support existing resources within the community to build and maintain YCCO’s social needs screening and support network.Serves as a liaison, in coordination with Provider Relations, between internal CCO (Community Care Organization) staff and external partners to facilitate collaboration and maintain positive community relations.Provides support with any partnerships between YCCO and Tribal or Urban Indian Health Program entities, including contract oversight and issue resolution as appropriate.Social Needs Project LeadershipEngages with OHA around related social needs and benefit meetings, work sessions, and activities to ensure new information is incorporated in program processes.Develops and maintains social needs capacity assessment at least annually, with analysis of available local social needs organizations and capacity to meet regional member needs.Serves as main liaison for Community Information Exchange implementation internally and with community partners.Directs social needs screening implementation practices with community partners, social needs providers, and support with social needs integration and reporting efforts community-wide.Leads collaborative work within and across teams that may include, but is not limited to, other Project Specialists, CHW’s, CM Case Managers, Nurse Case Managers, Community Providers, Health Services Supervisor, Traditional Health Worker Liaison.Develops workflows, Standard Operating Procedures (SOP), and process improvement plans to guide social needs benefit and health related services review, authorization, service delivery, and monitoring.Acts as an individual contributor to other CCO initiatives, Quality Assurance and Compliance activities, and assists with data reviews and processes.Champions health equity and YCCO efforts to redistribute power and resources; recognizes, reconciles, and rectifies historical and contemporary injustices within the YCCO healthcare and social service systems.Social Needs Focus Areas Climate Devices, Nutrition & Housing ServicesMaintains a current understanding of local resources and services.Develops and maintains positive relationships and working agreements with CCO, local vendors, and services providers.Works with contracts department to create Memorandums of Understanding (MOU) or agreements to establish services and devices (if necessary).Works with Finance to determine inventory and supply demand in case of climate emergency.Serves as a liaison, and/or supports CCO liaison efforts, between vendors, service providers and members during conflicts / issues with a goal of preventing the loss of partnerships and/or contracts.Identifies gaps in resources and services and identify solutions to address these gaps.Prepares social needs related reports.Regularly attends YCCO’s Community Advisory Council (CAC) meetings to coordinate social needs screening and program processes with Children’s Health Insurance Program (CHIP) related programs and interventions.Essential Department & Organizational FunctionsWorks to cultivate and develop inclusive and equitable services, and working relationships with diverse groups of employees, community partners, and community members.Manages projects end-to-end related to social needs initiatives and improvement activities.Participates in the preparation and submission of regulatory and contract required deliverables.Works closely with other YCCO departments, including Compliance to assist with audits; including the External Quality Review (EQR), as needed.Attends in person Annual Company Conference in Oregon; typically held in the fourth week of September.Provides cross-training on specific job responsibilities.Meets identified goals that contribute to departmental goals.Knowledge, Skills, & AbilitiesKnowledge of social determinant of health and their relationship to a person’s overall well-being.Ability to build relationships and network with individuals at all levels, both internal and external to the organization.Ability to work in an environment with diverse individuals, open-minded and non-judgmental including working with those who may hold different values / experiences, such as cultural needs, language, economic status, life experience, etc.Exhibits strong organizational and record keeping skills including the ability to handle multiple priorities and demands in a dynamic work environment.Excellent organizational skills including ability to handle multiple priorities and demands simultaneously in a dynamic work environment while maintaining high attention to detail and accuracy.Familiarity with project management concepts and principles.Supervisory Responsibilities -This position has no supervisory responsibilityQualificationsAbility to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.Education & ExperienceRequired:Bachelor’s degree in Community Health, Communications, Public Health, Social Work, Public Administration, or related field,Two (2) years of experience in Health Insurance, Utilization Management, Program Coordination, Planning, and Development of Community Resources.OR:Any combination of education and experience that would qualify candidate for the position.Preferred:Project Management or Administrative Management experience.Bilingual Skills (English / Spanish, Skills Pay available).Systems experience with Medicaid population.Experience working with affordable housing programs.Certificates, Licenses and/or RegistrationsThis position does not require any certificates, licenses, or registrations.