Clinical Support Coordinator 2 - 96052
Wollborg Michelson Recruiting
Rancho Cordova, CA
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JOB DETAILS
LOCATION
Rancho Cordova, CA
POSTED
15 days ago
Clinical Support Coordinator
Job Summary
The Clinical Support Coordinator reviews and processes CalAIM Community Supports referrals and authorizations, coordinates member access to services, maintains accurate documentation and reports, and supports internal and external stakeholders to ensure compliant and efficient delivery of Community Supports services.
Responsibilities
- Review CalAIM Community Supports screening documents to determine member eligibility.
- Follow up with internal staff and providers to support successful referral and enrollment into Community Supports services.
- Process daily service authorizations and denials for requested Community Supports services.
- Perform data entry, tracking, and case documentation for all referred members, including enrollment status, authorizations, encounter data, care coordination activities, clinical case records, and regulatory reports.
- Support reconciliation of provider invoicing and claims.
- Prepare and send communications to Community Supports providers to ensure timely submission of deliverables and reports.
- Support implementation of CalAIM Community Supports trainings for internal teams, external providers, and community-based organizations.
- Provide ongoing education regarding Community Supports services and referral processes.
- Identify and help address gaps and barriers in the care coordination process to improve member access to services.
- Review provider reports to ensure accurate data collection and reporting.
- Respond to inquiries regarding service authorization request status.
- Actively participate in multidisciplinary team meetings to coordinate member care and support member retention in Community Supports services.
- Conduct outreach calls to members, as needed, to verify engagement in Community Supports services.
- Ensure adherence to all applicable state and federal rules and regulations.
- Perform other related duties as assigned.
Requirements
- High school diploma or equivalent.
- Strong attention to detail.
- Excellent written and verbal communication skills.
- Experience with data entry and/or utilization management.
- Proficiency with Word, Excel, Outlook, and Teams.
Skills
- Detail-oriented with strong organizational abilities.
- Clear, professional written and verbal communication.
- Accurate and efficient data entry and documentation.
- Ability to collaborate effectively with cross-functional teams and external providers.
- Capability to interpret and apply program guidelines and regulatory requirements.
- Comfort working with electronic systems and reports.
Summary Qualification
- High school diploma or equivalent educational background.
- Experience in healthcare, care coordination, utilization management, or a related administrative support role.
- Familiarity with health plan operations, Medi-Cal, or community-based services is preferred.
- Experience working in electronic medical record or similar clinical information systems is preferred.
- Demonstrated interest in or commitment to social services and supporting vulnerable populations.
Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.
About the Company
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