Clinical Services Coordinator, Intermediate

Your Role

The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serve as an initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that members are effectively and efficiently managed through the medical/disease management process as needs require and in helping the RN care manager or social worker in arranging appropriate medical equipment (DME), home health, follow-up appointments, and other services related to care coordination.

Your Knowledge and Experience

• A minimum of a high school diploma or equivalent
• A minimum of 3 years of relevant experience
• A minimum of 1 year experience in a managed care environment.
• Bi-Lingual, English/Spanish is preferred
• Experience using MS Office applications including Word, Excel, PowerPoint, Outlook and Teams. Experience using Salesforce preferred.
• Knowledge of clinical workflow to assist nurses with research and issue resolution preferred
• Health insurance/ managed care experience (Commercial, Medicare, and Medi-Cal) preferred. Knowledge of Medicare eligibility criteria preferred.
• Experience working with community resources and member advocacy preferred
• Experience working in an integrated practice in a triad model of care preferred