Located in Grants Pass, OR
Pay: $20-$23
Job Full Description
Position Summary
The SDoH Coordinator is responsible for the timely processing of prior authorization requests related to Health Related Social Needs (HRSN) and Social Determinants of Health (SDoH) services. This role serves as a key resource for internal teams and community partners, helping remove barriers to healthcare access by ensuring service requests are reviewed accurately, efficiently, and in compliance with state and federal guidelines. This is a temporary position till end of August. The starting wage is $20-$23 an hour
Key Responsibilities
- Review and process SDoH service requests according to established policies and required timelines.
- Serve as a resource regarding authorization requirements, eligibility criteria, and benefit guidelines.
- Research and apply applicable federal regulations, state requirements, and health plan policies when making service determinations.
- Verify member eligibility and benefit coverage.
- Prepare and distribute authorization decisions, including approvals, extensions, and adverse determinations, while communicating appeal and grievance rights.
- Submit monthly claims related to HRSN benefits, including housing, utilities, storage, climate support, home modifications, outreach, and engagement services.
- Reconcile provider invoices and ensure accuracy between billing records and system documentation.
- Monitor and respond to member, provider, and community partner inquiries.
- Review website inquiries and referral platforms to ensure timely follow-up and coordination of services.
- Maintain current knowledge of Oregon Administrative Rules (OARs), Medicaid guidelines, and organizational policies.
- Identify opportunities for process improvement and workflow efficiency.
- Build and maintain positive working relationships with providers, community organizations, and internal stakeholders.
- Escalate concerns appropriately and collaborate with leadership to resolve issues.
- Maintain accurate records and documentation while ensuring compliance with HIPAA and confidentiality standards.
- Perform other duties as assigned.
Qualifications
Education
- High School Diploma or GED required.
Experience
- One to two years of experience in healthcare, social services, care coordination, benefits administration, community outreach, or a related field preferred.
- Experience working with Social Determinants of Health (SDoH), Health Related Social Needs (HRSN), Medicaid programs, or community resources is highly desirable.
Technical Skills
- Familiarity with healthcare operations and insurance benefits.
- Strong written and verbal communication skills.
- Excellent organizational and time-management abilities.
- Proficiency with Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint.
- Knowledge of HIPAA regulations and confidentiality requirements.
- Strong customer service skills and ability to manage challenging situations professionally.
Professional Skills
- Ability to prioritize and manage multiple tasks in a fast-paced environment.
- Strong attention to detail and problem-solving abilities.
- Ability to work independently while collaborating effectively within a team.
- Demonstrated professionalism, sound judgment, and discretion with sensitive information.
- Adaptable, resourceful, and comfortable working with changing priorities.
- Commitment to equity, inclusion, and understanding the impact of social determinants on health outcomes.
Medford, OR
1951
3523 Arrowhead Drive
Suite 100
Medford, OR 97504
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