Your Role
The Clinical Services Coordinator (CSC) will report directly to the Supervisor of Promise Medi-Cal Care Management.This individual will interact telephonically and electronically with members and providers as per established protocol or direction to ensure that members are effectively and efficiently managed through the outreach, engagement, and care management processes. The CSC will directly help members as their health needs require and will support the Promise Case Managers and/or Social Workers in arranging appropriate follow-up appointments, and other services related to the member’s care coordination.Your WorkIn this role, you will:Demonstrate cultural competence to work effectively, respectfully, and sensitively within the client’s cultural contextKnowledge of community resources and advocacyIncorporation of all Medi-Cal, Cal-AIM and Population Health management requirements with NCQA/HEDIS measures with little to no direct supervision. Show ability to resolve or direct member FAQs, i.e., plan benefits, coverage, network, preferred facilities, provider searches, claims, authorizations, etc.Serve as primary point of contact for members and providersDeliver administrative and clerical support to the Promise Case Mangers as assignedActs as a liaison to gather information and track all patients referred to the care management programDocuments all patient specific information in applicable information systems, connecting to other departments as appropriateTelephonic communication with members as directed by established and trained protocols to conduct general outreach, health risk assessment (HRA), or other program specific needsManage centralized program toll-free phone lines and email inbox to receive, respond, and triage program inquiries based on eligibilityOther duties as assigned including, but not limited to, Health Risk Assessment (HRA), assist in coordinating care for Medi-Cal population, generating referrals to appropriate care management program or team to support member needsYour Knowledge and ExperienceRequires high school diploma or equivalentA minimum of 3 years relevant experienceA minimum of 3 years’ combined experience in a clinical practice in the hospital, outpatient, health plan, community health, or care management settingBilingual preferred