Clinical Support Coordinator 2

Support with implementation of CalAIM Community Supports trainings to internal teams, external providers, and community-based organizations by providing ongoing education about CalAIM Community Supports services and referral process. Perform data entry, tracking and case documentation for all members referred for services, including enrollment status, authorizations, encounter data, care coordination activities, clinical case records and regulatory reports.

Our Client, a Health Insurance company, is looking for a Clinical Support Coordinator 2 for their Long Beach, CA/Hybrid location.
 
Responsibilities:

• Review CalAIM Community Supports Screening documents to determine member eligibility for CalAIM Community Supports.
• Follow up with internal staff and providers to support the successful referral and enrollment of members into CalAIM Community Supports services.
• Process daily service authorizations and denials for requested Community Supports services.
• Perform data entry, tracking and case documentation for all members referred for services, including enrollment status, authorizations, encounter data, care coordination activities, clinical case records and regulatory reports.
• Support with reconciling provider invoicing and claims.
• Support with sending communications to Community Supports Providers to ensure timely submission of deliverables and reports.
• Support with implementation of CalAIM Community Supports trainings to internal teams, external providers, and community-based organizations by providing ongoing education about CalAIM Community Supports services and referral process.
• Identify and help to address gaps/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 CalAIM Community Supports services.
• Conduct outreach calls to members, as needed, to verify engagement in Community Supports services.
• Participate actively in ensuring that all state and federal rules and regulations are followed.
• Perform other assigned duties, as required.

 
Requirements:

• High school diploma or GED required.
• 2-4 years’ experience required.
• Top 3 Required Skills:
• Detailed-oriented
• Excellent written and verbal communication
• Experience with data entry and/or utilization management
• Preferred/nice to have skills:  
• Health Plan and/or Medi-Cal experience/knowledge
• Experience working in electronic medical record systems
• Interest/passion for social services delivery
• Software Skills Required:      
• Word, Excel, Outlook, Teams

 
Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities