Your Role
The Care Management Department is seeking a dedicated and compassionate Clinical Service Coordinator (CSC) to join our team. The Clinical Service Coordinator will report to the Supervisor of Care Operations. The CSC will play a vital role in outreach and engagement efforts with our members, introducing them to care management services, and conducting assessments to identify their needs. The successful candidate will interact telephonically with members to assist with simple care coordination needs and facilitate connections between members and appropriate services, including internal nurse care managers, vendors, and behavioral health providers.
Your Work
In this role, you will:
- Conduct telephonic outreach efforts to engage members andintroduce them to caremanagement services.
- Completethoroughassessmentstoidentifymemberneedsandcaregaps
- Maintain accurateand up-to-datememberrecordsanddocumentation ofall interactions and services provided
- Conductfollow-upcallstoensuremembers’needsarebeingmet
- Provide members with information and resources about available care management services and how to access them
- Provides administrative/clericalsupporttomedicalanddiseasemanagementprograms.
- Acts as aliaison, gathers information, and track all patients referred to the care management programs.
- Assists in coordinating care for specific high risk/high-cost patient population, including referrals tocommunity resources, facilitationofmedical services, referral toancillary providers, etc.
- Assistsinverifyinghealthplanbenefitsandcoordinatingambulatoryservices.
- Demonstratesculturalcompetencetoworkeffectively,respectfully,andsensitivelywithin theclient’sculturalcontext.
- Assistswithpreceptingresponsibilitiesfornewhiresandauditingefforts.
Your Knowledge and Experience
•A minimum of a high school diploma
•A minimum of 3 years of relevant experience
•A minimum of 1 year experience in a managed care environment.
•Health insurance/ managed care experience (Commercial, Medicare, and Medi-Cal)
•Community resources and advocacy
•Ability to identify issues and develop effective solutions to meet members' needs
•Flexibility to adjust to changing circumstances and member needs
•Strong verbal and written communication skills to effectively convey information to members and colleagues