The Resource Specialist maximizes hospital resource utilization and coordinates post-hospital care or provides patient resources, primarily supporting Social Services, Inpatient Case Management, and Population Health teams. Key duties involve communication with payers and outside agencies to facilitate patient discharge and tracking resources provided for disposition.
Requirements summary
A high school diploma is preferred, though a Bachelor's degree in Social Work, Psychology, or Health Sciences is strongly preferred. Candidates must have one or more years of experience in a hospital, medical setting, or public health role, requiring knowledge of medical terminology.
high schoolbachelor degreeCommunicationCoordinationProblem-SolvingOrganizationEMR DocumentationAuditingCollaborationInitiativeCritical ThinkingInsurance VerificationDischarge PlanningCase Management SupportPatient Care RoundsUtilization ManagementAdvanced DirectivesResource Education
Job description
At NorthBay Health, the Resource Specialist (RS) will perform a combination of duties designed to maximize the utilization of hospital resources and coordinate post-hospital care or offer resources and education for patients in support of Social Services, including supporting Inpatient Case Management and Population Health teams per business needs.
This RS position is patient-facing and will primarily serve/support the Social Services department but will be cross trained to also support case management and population health RS roles to collaboratively improve patient access and help reduce readmission.
The responsibilities of these comprehensive duties include communication and coordination with payers and outside agencies to assist with patient discharge and supporting IPCM/Social Work accountabilities.
The Resource Specialist at NorthBay Healthcare must be able to demonstrate adherence to the department and system policies, procedures, quality assurance, guidelines and goals of the department and the organization.
The Resource Specialist takes day to day direction for priorities from the Inpatient Case Management/Social Work Supervisor, Social Worker or designee.
PRIMARY JOB DUTIES Maintains regular communication with Inpatient Case Managers (IPCM), Social Workers, appropriate management staff, outside agencies and other hospital departments.
Prepares necessary paperwork for the Social Workers and IPCM.
Provides support to the Social Worker and IPCM: faxing, copying charts, follow-up phone calls, resource education to patients, coordinating Lyft/taxi rides, providing clothes/items to the homeless, tracking of shelter beds, follow-up appointments, with documentation in the EMR system and Navi Health per policies and procedures.
Initiates and documents Advanced Directive paperwork with patients as directed.
Initiates, documents, and tracks provided resources and any items related to discharge planning and disposition (home, shelter, wellness checks, etc.) Interacts with review organizations, third party payers, and outside agencies to expedite resources for patient discharge plans and maximize hospital reimbursement for services provided.
Documents denials, authorizations, and health plan updates in the Electronic Health Record.
Appropriately notifies Medical Auditor, Social Worker and/or Supervisor of authorization issues.
Interacts with patients and/or families to provide resource options, as directed.
Verifies insurance benefits and contracted agencies for patient care options post discharge.
Coordinates post-hospital care (SNF, DME, Home Health, Crisis, Shelter bed, etc.) in accordance with the interventions and discharge plan created by the IPCM and/or Social Worker.
Maintains and updates resources on K drive and notifies RS Lead and SW Supervisor of updates.
Attends and participates in patient care rounds, as appropriate.
Upon the request of IPCM or SW, produces and distributes all necessary correspondence.
Produces necessary correspondence, including hospital transfer information, for the IPCM/SW.
Organizational standards for Joint Commission, Department of Human Services, Patient Safety, CMS Conditions of Participation, and the Department of Health will be met.
Performs audits (i.e.
Anticipated Discharge Date) as assigned.
Performs special functions and other duties as assigned.
Interpersonal Skills and Values Demonstrates NorthBay Health’s True North Values
Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care. Why NorthBay Health NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics. We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions. We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities. NorthBay Health Benefits Options NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance. Compensation Structure NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements. Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs. Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States. Notice to Recruitment Agencies NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings. More Information Visit NorthBay Health Careers for recruitment FAQs and additional information.
