THP Specialty Care Administrator

DEPARTMENT SUMMARY: As the nations largest and most experienced provider of LGBT medical and mental health services we help LGBTQ people lead healthier happier lives by keeping their minds and body well. All services are free or at a low cost. Were also one of the few Federally Qualified Health Centers in the nation with providers who specialize in primary care for LGBTQ people and with a research team working to advance the care and treatment of people in our community.

JOB SUMMARY:The Trans Health Program Specialty Care Administrator oversees comprehensive care coordination for gender-affirming services. This includes managing provider referrals preparing and supporting patients through surgery and procedure planning and collaborating with providers and care teams to ensure timely access to care. Key responsibilities include organizing patient information securing authorizations notifying and scheduling patients maintaining accurate documentation and retrieving/indexing consult notes. Strong communication attention to detail and insurance verification are essential to ensure continuity of care.

ESSENTIAL FUNCTIONS

Care Coordination & Referral Management

• Lead and maintain the full referral lifecycle in alignment with department policies Medi-Cal Medicare Managed Care Plans and private insurance requirements
• Independently determine referral eligibility and authorization needs ensuring all referrals meet payer-specific guidelines and compliance requirements
• Collaborate with eligibility and benefits staff to resolve coverage or eligibility concerns
• Partner with Case Management and Behavioral Health to support letter writing and mental health screening
• Coordinate and monitor all specialty referrals ensuring timely scheduling completion and documentation within the EHR
• Maintain ongoing communication with specialty providers to retrieve consult notes resolve issues and facilitate additional services or authorizations
• Develop and maintain systems to track and reconcile referral statuses ensuring continuity of care and closing gaps in services
• Collaborate with medical providers specialists Case Management and Behavioral Health to support clinical workflows including letters of support and care planning
• Serve as part of the multidisciplinary care team to facilitate specialty referrals and provide regular updates on referral status insurance issues barriers and patient needs
• Serve as a primary liaison between specialty consultants Health Services internal departments and insurance entities to ensure timely coordinated care delivery
• Exercise independent judgment when addressing complex coordination issues and escalating concerns appropriately

Patient Communication & Advocacy

• Communicate referral details appointment instructions and care expectations to patients in a timely and supportive manner
• Identify and troubleshoot barriers to accessing specialty care (e.g. insurance transportation language system navigation) escalating concerns when needed
• Advocate for patients by coordinating with internal and external partners to ensure seamless transitions and equitable access to care
• Provide education and counseling on the referral and care coordination process

Other Responsibilities

• Participate in quality improvement initiatives focused on enhancing referral workflows patient experience and process efficiency
• Conduct or support referral-related data audits accuracy reviews and assist with resolving patient grievances as they relate to GAS referrals to inform quality improvement efforts
• Ensure compliance with HIPAA OSHA and organizational standards
• Participate in staff meetings agency meetings planning meetings and other meetings as needed
• Comply with requirements of OSHA HIPAA and other applicable regulations
• Other duties as assigned

QUALIFICATIONS

• Medical Assistantcertification from approved training programand/or specialty care referral and utilization managed care experience
• Minimum 3 years experience in an outpatient healthcare setting. Case Management experience preferred.
• Gender-affirming care coordination and surgical planning experience preferred
• Knowledge of ICD-9/10 codes and CPT coding
• Strong communication organizational and interpersonal skills with a high level of attention to detail
• Proficient in Microsoft Office EHR and other healthcare software
• Self-motivated with the ability to handle multiple tasks and maintain patient confidentiality.
• Able to work independently with minimal supervision
• Bilingual (English/Spanish) is a plus
• Experience working with or knowledge of the LGBTQ community and related issues
• Passion for the Centers mission and a commitment to diversity and inclusion
• Demonstrated ability to work effectively with people of diverse races ethnicities nationalities sexual orientations gender identities gender expression socio-economic backgrounds religions ages English-speaking abilities immigration status and physical abilities in a multicultural environment

The Los Angeles LGBT Center is an Equal Opportunity Employer and is committed to fostering diversity within its staff. Applications are encouraged from all persons regardless of their race color ancestry religious creed national origin sex sexual orientation gender identity gender expression medical/physical/mental condition pregnancy/childbirth and related medical condition age marital status or veteran status.

The Center requires that all staff working in Health Services clinical site locations receive the most up-to-date Influenza vaccinations and strongly recommends that staff also receive the latest COVID-19 vaccine. Staff not working at any of the Centers clinical sites are encouraged to receive the latest COVID-19 and Influenza vaccines but are not required to do so. For more information please contact.