Surgical Health Services Coordinator

ARE YOU A CASE MANAGER OR HAVE TREATMENT PLAN EXPIERENCE?

WANT

SOMETHING DIFFERENT OR NEW LETS TALK ABOUT THIS AMAZING OPPORTUNITY!

Position Title Surgical Health Services Coordinator (SHSC) Agency / Program L&I - Surgical Quality Care Program (SQCP) The SHSC supports surgeons participating in the SQCP, and works with injured workers (state-fund or self-insured), providers, employers, claim managers and vocational services. Washington Labor & Industries+3Washington Labor & Industries+3Washington Labor & Industries+3 Purpose / Mission To improve clinical and work-outcome results for injured workers undergoing surgical care by: coordinating care between the surgical provider, attending provider, worker, employer, claim manager and vocational provider; Washington Labor & Industries+2Washington Labor & Industries+2 ensuring timely surgical referrals and transitions, return-to-work planning, and barrier mitigation; Washington Labor & Industries+2Washington Labor & Industries+2 facilitating documentation of best practices for the program (e.g., pre/post operative Activity Prescription Forms, release-to-work plans) so the surgeon/clinic can achieve higher adoption levels in the SQCP incentive model. Washington Labor & Industries+1 Core Responsibilities / Key Duties Based on the SQCP Manual and SHSC "Keys to Success" documentation, typical duties include: 1. Liaison/Coordination Act as a point of contact between the injured worker, the attending provider, surgical provider, employer, claim manager, vocational services, and other parties. Washington Labor & Industries+1 Facilitate transitions of care: e.g., from attending provider to surgical provider, emergency department to surgical clinic, post-surgery back to non-surgical care when indicated. Washington Labor & Industries Ensure continuity of care and that all appropriate referrals are made and tracked (for example imaging, physical therapy, functional capacity evaluation) and barriers resolved. Washington Labor & Industries+1 2. Return-to-Work / Release-to-Work Planning Collaborate in creation of release-to-work plans (pre and post surgery) and help ensure workers, employers, and providers understand work restrictions, capacities, and expectations. Washington Labor & Industries+1 Monitor progress against those plans, identify delays or issues, and escalate to the provider or employer as appropriate. Washington Labor & Industries 3. Barrier Assessment and Follow-Up Conduct assessments (e.g., pain & function scales, functional recovery questionnaires), identify barriers to recovery (medical, vocational, psychosocial, work environment), and implement or coordinate mitigation strategies. Washington Labor & Industries+1 Ensure referrals to community services or vocational services when needed. Washington Labor & Industries 4. Documentation and Data Management Maintain tracking lists and tasks (e.g., daily checking for new surgical referrals, reviewing provider chart notes, managing a caseload of surgical-referral claims). Washington Labor & Industries+1 Use the L&I web-based system (Occupational Health Management System - OHMS) or equivalent to document coordination activities and outcomes. Washington Labor & Industries+1 Support the surgeon/clinic's performance in the SQCP by ensuring documentation of key best-practice metrics (e.g., pre/post Activity Prescription Forms, timely surgery, return-to-work tracking) to maximize adoption level incentives. Washington Labor & Industries+1 5. Provider/Clinic Support & Education Assist the surgical provider and clinic staff in implementing the occupational-health best practices as defined by L&I (e.g., opioid prescribing guidelines, functional outcomes monitoring) and support training/education of staff. Washington Labor & Industries Reduce administrative burden on the surgical provider by handling coordination tasks, allowing the surgeon to focus on care rather than paperwork. Washington Labor & Industries 6. Billing/Service Codes (if part of contract) If the SHSC is approved by L&I as a provider, they may bill using designated billing codes in the Medical Aid Rules & Fee Schedule (MARFS) for state-fund claims. Washington Labor & Industries+1 Qualifications / Minimum Requirements From L&I "Health Services Coordination" and other SHSC documentation: Bachelor's degree (or equivalent) and at least 3 years' experience in direct patient care, return-to-work coordination, workers' compensation, occupational health care OR 7 years' experience in those settings. Washington Labor & Industries+1 Ability to obtain and maintain an L&I Provider ID (if billing services) and comply with L&I provider standards. Washington Labor & Industries+1 Strong oral and written communication skills; ability to collaborate with health care professionals, patients, employers, and insurance/claims staff. Washington Labor & Industries Data management/tracking skills; ability to document coordination activities, monitor outcomes, analyze provider data; comfort with information systems. Washington Labor & Industries+1 Knowledge or experience with return-to-work concepts, functional capacity evaluations, occupational health best practices.

Training:

Required to complete L&I training modules for SHSC/health services coordination. Washington Labor & Industries+1 Workload and Caseload Guidelines For surgical SHSCs, L&I recommends no more than ~600 initiated claims annually per coordinator (to ensure quality of service). Washington Labor & Industries For general health services coordination HSCs, guideline is no more than ~1,650 claims annually. (But for SHSC, the lower number reflects the more complex surgical-referral cases.) Washington Labor & Industries In a typical clinic supporting 7-10 surgeons may correspond to one full-time SHSC. Washington Labor & Industries Key Performance Indicators / Success Metrics Timeliness of pre-operative and post-operative Activity Prescription Forms (APFs) submission for eligible surgical claims. Washington Labor & Industries+1 Percentage of surgical claims with documented release-to-work plans, and actual return to work/transition outcomes. Washington Labor & Industries Reduction in transition delays (e.g., time from authorization to surgery). Washington Labor & Industries Documentation accuracy and completeness of claim coordination notes, barrier assessments, follow-up tasks. Washington Labor & Industries Provider adoption level in the SQCP (low, medium, high, sustaining) partly depends on the SHSC's effectiveness. Washington Labor & Industries Work Environment / Relationships The SHSC is typically embedded in a surgical clinic or health-services organization that supports surgical providers participating in the SQCP. Washington Labor & Industries Works closely with: injured workers, surgeons, surgical PAs/Nurse Practitioners, attending providers, employer representatives, claim managers, rehabilitation/vocational providers. May require access to surgical schedules, EMR/charting, claim systems, and internal workflows to monitor progress and tasks. Might involve some remote work/phone follow-up, but typically interactive with both clinical and administrative staff. The role may also require responsiveness to urgent priorities when surgical patients experience complications or return-to-work issues arise. (See example in "Success Stories".) Washington Labor & Industries Skills / Attributes Excellent coordination and follow-up skills — able to track many moving parts, ensuring no steps fall through the cracks. Strong problem-solving orientation — identify barriers, escalate appropriately, and assist in designing mitigation strategies. Good interpersonal skills — able to engage with injured workers (often in stressful situations), providers, and employers. Proficiency in documentation and data systems; attention to detail with compliance and best-practice metrics. Knowledge of workers' compensation system (especially in WA), occupational health best practices, return-to-work principles. Ability to work independently but also collaborate in a team environment. Adaptability and ability to manage a dynamic workflow; some cases may need expedited action (e.g., for surgical referrals or complications).

Pay:

$30.00 - $38.00 per hour

Work Location:

In person