Job Specifications

SANTA CRUZ COUNTY

Under direction, to assess client medical needs; to coordinate medical services and benefits for indigent eligible patients; to facilitate medical care from service providers and health care organizations; and to do other work as required.

Incumbents of this class manage a caseload of medically needy adults for whom they arrange appropriate medical and ancillary treatment; typically positions are assigned patients with complex or chronic medical conditions or individuals requiring hospitalization and post-inpatient assistance.

Arranges appropriate medical services for a caseload of indigent adults; assesses client needs based on established medical condition and authorizes treatment for diagnosis within the scope of coverage; contacts service providers and schedules tests, consultations and specialist appointments; coordinates ancillary services such as transportation, physical, occupational or speech therapies, medical supplies and pharmaceutical prescriptions; may assist in discharge planning for inpatients and arrange for placement in skilled medical facilities, convalescent hospitals or in-home care; assists clients of diverse ethnic and social background such as undocumented workers, mentally disturbed, transient residents and pregnant teenagers; serves as intermediary for the client working with eligibility workers, program managers, clinic staff, and provider organizations to ensure adequate medical care within program guidelines; assesses patient's social, emotional and financial condition for possible referral to appropriate support services agency; prepares written reports and statistical summaries on program activities; corresponds with providers, completes case progress notes and other appropriate documentation.

• Working knowledge of the medical care delivery system and the various public and private organizations serving the medically indigent;
• Working knowledge of medical diagnosis, treatment procedures, discharge planning and appropriate levels of care;
• Working knowledge of reimbursement systems for medical services;
• Working knowledge of medical terminology and practices;
• Some knowledge of common community resources, other public assistance programs and medical service providers;
• Some knowledge of public medical insurance programs, eligibility requirements and scope of coverage.

• Manage a caseload to meet client needs for a wide variety of medical services;
• Formulate cost-effective alternatives for client health care treatment;
• Establish cooperative working relationships with service providers, community resource agencies and clients;
• Interview effectively to gather pertinent medical, social and financial information;
• Prepare reports, case records, treatment plans and other written documents;
• Communicate effectively both orally and in writing;
• Assess needs, develop treatment plans and determine appropriate community resources for client rehabilitation.

Training and Experience: Any combination of training and experience, which would provide the required knowledge and abilities, is qualifying. Typical ways to obtain these knowledge and abilities would be:

College or course work in social welfare and medical social services with a year of experience which provides the knowledge and abilities listed above,

Or

Two years experience in a hospital or medical care agency or government sponsored insurance agency performing social services, discharge planning, utilization review or similar duties.