Current jobs related to Clinical Services Coordinator, Intermediate - El Dorado Hills - Blue Shield Of California
-
Appeals and Grievances Representative, Intermediate
52 minutes ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Clinical Appeals and Grievances team researches and resolves member/subscriber grievances, appeals and complaints, and interprets and explains health plan benefits, policies, and procedures to appellant. The AGD - Intermediate coordinators will report to the team’s Operational Supervisor. In this role you will clarify issues, educate...
-
Pharmacy Technician, Intermediate
4 days ago
El Dorado Hills, California, United States Blue Shield of CA Full time{"title": "Pharmacy Technician, Intermediate", "description": "Job SummaryWe are seeking a highly skilled Pharmacy Technician, Intermediate to join our team at Blue Shield of CA. In this role, you will play a critical part in ensuring the efficient and accurate resolution of outpatient pharmacy benefit inquiries.Key ResponsibilitiesCoordinate and implement...
-
Appeals and Grievances Representative, Intermediate
21 hours ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Appeals and Grievances Pharmacy team researches and resolves member/subscriber grievances, appeals and complaints, and interprets and explains health plan benefits, policies, and procedures to appellant. The AGD - Intermediate coordinators will report to the team’s Operational Supervisor. In this role you will clarify issues, educate...
-
El Dorado, Arkansas, United States South Arkansas College Full timeOverview Department: Academic Affairs Job Category: Education Job Type: Part-time Salary: $30 per hour Minimum Education: 2 Year Degree Degree Title: Licensed EMS Instructor Minimum Experience: 2 Years (Paramedic/EMS) Required Travel: 25% Job Status: Accepting Applications Position Summary: Role Overview: The Clinical Education Coordinator is tasked with...
-
Senior IT Project Coordinator
4 weeks ago
El Dorado, Arkansas, United States Murphy USA Full timePosition Overview:The Senior IT Project Coordinator plays a crucial role in orchestrating and overseeing IT projects and initiatives from inception to completion. This position is integral to the success of high-priority departmental projects that bolster the Technology Services Infrastructure Engineering, Infrastructure Operations, and End User Services...
-
Agency Coordinator
3 weeks ago
El Dorado Hills, United States Combined Insurance Full timeJob DescriptionJob DescriptionPOSITION SUMMARY The Agency Coordinator (AC) is primarily responsible for prospecting new customers independently and meeting with current customers to sell Insurance products within a specific geographic area and to support the delivery of sales objectives for the assigned area. The Agency Coordinator is also responsible for...
-
El Dorado, Arkansas, United States South Arkansas College Full timeJob Summary:This is a part-time position responsible for the instruction and management of clinical/practicum experiences and assigned classes within the Emergency Medical Services (EMS) Program at South Arkansas College. The successful candidate will maintain professionalism within their specialized field, including currency and required certifications. Key...
-
El Dorado, Arkansas, United States South Arkansas College Full timeJob Summary:This is a part-time position responsible for the instruction and management of clinical/practicum experiences and assigned classes within the Emergency Medical Services (EMS) Program at South Arkansas College. The successful candidate will maintain professionalism within their specialized field, including currency and required certifications. Key...
-
Reception Operations Coordinator
4 weeks ago
El Dorado Hills, California, United States The Management Association, Inc. Full timeJob OverviewCompany: The Management Association, Inc.Position: Front Desk AssistantLocation: Not specifiedRole Summary:The Front Desk Assistant plays a vital role in delivering outstanding customer service and administrative support to all visitors. This position requires collaboration with team members, handling special projects, and performing various...
-
Reception Coordinator
4 weeks ago
El Dorado Hills, California, United States The Management Association, Inc. Full timeJob OverviewCompany: The Management Association, Inc.Position: Front Desk AssistantLocation: Not specifiedPosition Type: Full-Time, Non-ExemptSalary Range: $17-$19 DOEABOUT THE COMPANY:The Management Association, Inc. is a premier community management organization dedicated to fostering vibrant communities. Our approach is rooted in integrity, trust, and a...
-
Substance Use Disorder Services Coordinator
2 weeks ago
El Dorado, Kansas, United States South Central Mental Health Counseling Center Full timeJob Summary:South Central Mental Health Counseling Center is seeking a highly skilled and dedicated Substance Use Disorder Services Coordinator to join our team. As a key member of our organization, you will be responsible for developing, overseeing, and providing Substance Use Disorder services in our offices. This role requires strong clinical supervision...
-
Clinical Nurse Practitioner
5 days ago
El Dorado Hills, California, United States Marshall Medical Center Full timeJob Title: Clinic Licensed Vocational NurseJob Summary:The Licensed Vocational Nurse (LVN) at Marshall Medical Center's outpatient clinics plays a vital role in delivering high-quality patient care. Working closely with medical caregivers, the LVN ensures that patients receive timely, dignified, and compassionate care.Key Responsibilities:Coordinate patient...
-
Medical Services Coordinator
3 weeks ago
El Dorado, Kansas, United States Flint Hills Full timeJob SummaryFlint Hills is seeking a highly skilled Nursing Coordinator to join our team. As a key member of our healthcare staff, you will play a vital role in coordinating medical services for individuals in our care.Key ResponsibilitiesMedication Management: Conduct medication delegation training, annual medication recertification, and remedial re-training...
-
Medical Office Coordinator
2 weeks ago
El Dorado Hills, California, United States Medical Professionals Full timeJoin Our Team at Medical ProfessionalsAbout UsMedical Professionals is a reputable medical clinic serving the community since 1985. We are a single-specialty group dedicated to the treatment of diseases in the digestive tract and liver.Our MissionWe practice old-fashioned medicine by treating our patients with compassion and respect. Our team of medical...
-
Clinical Nurse Educator, Consultant
3 weeks ago
El Dorado Hills, California, United States Blue Shield of CA Full timeAbout the RoleThe Clinical Nurse Educator and Clinical Consultant will play a crucial role in ensuring the quality and compliance of our clinical staff. This position will report to the Quality Review Senior Manager and will be responsible for developing performance metrics, evaluating performance, and providing coaching to ensure that staff have the skills...
-
Clinical Nurse Practitioner
1 week ago
El Dorado Hills, California, United States Marshall Medical Center Full timeJob Title: Clinic Licensed Vocational NurseJob Summary:The Licensed Vocational Nurse (LVN) at Marshall Medical Center's outpatient clinics plays a vital role in delivering high-quality patient care. Working closely with medical caregivers, the LVN ensures that patients receive timely, dignified, and compassionate care.Key Responsibilities:Coordinate patient...
-
Clinical Case Management Specialist
4 weeks ago
El Dorado Hills, California, United States Blue Shield of California Full timeYour RoleThe Federal Employee Program (FEP) Care Management team is dedicated to executing integrated case management (CM) and disease management (DM) activities. This role requires the application of clinical judgment and independent analysis through collaboration with members and their care teams, including a multidisciplinary group and the member's...
-
Clinical Nurse Educator, Consultant
1 month ago
El Dorado Hills, United States Blue Shield of CA Full timeYour Role The clinical Quality Review team completes internal audits of front-line staff to ensure alignment with department processes and regulatory compliance. Quality Reviewers also provide coaching and work closely with business leaders to drive optimal results. The Clinical Nurse Educator, Consultant will report to the Quality Review Senior Manager. In...
-
Clinical Nurse Practitioner
2 weeks ago
El Dorado Hills, California, United States Marshall Medical Center Full timeJob SummaryWe are seeking a skilled Licensed Vocational Nurse to join our team at Marshall Medical Center's outpatient clinics. As a key member of our healthcare team, you will work closely with medical caregivers to deliver high-quality patient care in a timely and compassionate manner.Key ResponsibilitiesCoordinate patient flow and assist providers within...
-
Medical Office Coordinator
3 weeks ago
El Dorado Hills, California, United States Medical Professionals Full timeJoin Our Team at Medical ProfessionalsAbout UsMedical Professionals is a reputable medical clinic serving the community since 1985. We are a single-specialty group dedicated to the treatment of diseases in the digestive tract and liver.Our MissionWe practice old-fashioned medicine by treating our patients with compassion and respect. Our team of medical...
Clinical Services Coordinator, Intermediate
4 months ago
Your Role
The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serves as 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 Work
In this role, you will:
- Telephonic outreach to conduct the Health Risk Assessment (HRA) with the member
- Telephonic outreach to members as directed by protocol or RN care manager or social worker.
- Assists with system letters, requests for information and data entry.
- Back up to phones when needed.
- Provides administrative/clerical support to medical and disease management programs.
- Acts as a liaison, gather 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 to community resources, facilitation of medical services, referral to ancillary providers, etc.
- Documents all patient specific information in appropriate information systems.
- Assists in verifying health plan benefits and coordinating ambulatory services.
- Demonstrates cultural competence to work effectively, respectfully, and sensitively within the clients cultural context.
- Assists with precepting responsibilities for new hires and auditing efforts.
Your Knowledge and Experience
- A minimum of a high school diploma
- A minimum of 3 years of relevant experience
- A minimum of 1 year experience in a managed care environment.
- Bilingual in Spanish required
- Health insurance/ managed care experience (Commercial, Medicare, and Medi-Cal)
- Community resources and advocacy
- Practice integration in a triad model of care
Pay Range:
The pay range for this role is: $ 20.47 to $ 28.66 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
#LI-MM4
