YourRole
TheCareManagement Department is seeking adedicated and compassionate Clinical Service Coordinator (CSC) to join our team.The Clinical Service Coordinatorwill report to the SupervisorofCare 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 willinteract 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.
YourWork
Inthisrole,youwill:
- Conduct telephonic outreach efforts to engage members andintroduce them to care management 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
- Providesadministrative/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, facilitation ofmedical services, referral to ancillary providers,etc.
- Assistsinverifyinghealthplanbenefitsandcoordinatingambulatoryservices.
- Demonstratesculturalcompetencetoworkeffectively,respectfully,andsensitivelywithin the client’s cultural context.
- Assistswithpreceptingresponsibilitiesfornewhiresandauditingefforts.
YourKnowledgeandExperience
- Aminimumofahighschooldiploma
- Aminimumof3yearsofrelevantexperience
- Aminimumof1yearexperienceinamanagedcareenvironment.
- Bi-Lingual: Must be fluent in English and Spanish
- Healthinsurance/managedcareexperience(Commercial,Medicare,andMedi-Cal)
- Communityresourcesandadvocacy
- Abilitytoidentifyissuesanddevelopeffectivesolutionstomeetmembers'needs
- Flexibilitytoadjusttochangingcircumstancesandmemberneeds
- Strong verbal and written communication skills to effectively convey information to members and colleagues