Managed Care Outreach Coordinator

1 month ago

US California MO USA Pacific Clinics Full time
About Pacific Clinics

Pacific Clinics is a leading community-based nonprofit provider of behavioral and mental health services and support. Our team of over 2,000 employees speaks 22 languages and is dedicated to offering hope and unlocking the full potential of individuals and families through culturally responsive, trauma-informed, research-based services for individuals and families from birth to older adults.

Our Mission

We serve children, transitional age youth, families, adults, and older adults, offering a full range of mental and behavioral health services, foster care and social services, housing, continuing adult education, and early childhood education programs to Medi-Cal eligible individuals and families throughout Alameda, Contra Costa, Fresno, Kings, Los Angeles, Madera, Orange, Placer, Riverside, Sacramento, San Bernardino, San Francisco, Santa Clara, Solano, Stanislaus, Stockton, Tulare, and Ventura Counties.

What We Offer
  • Competitive Pay: $22.26 - $38.56 per hour, with compensation varying based on skills, experience, education, and location.
  • Comprehensive Benefits: Medical, dental, and vision benefits, retirement options, flex spending, EAP, and more.
  • Employee Engagement and Advocacy Opportunities: Support our justice, equity, diversity, and inclusion agenda across our agency and throughout the communities we serve.
About the Role

This position plays a critical role in engaging potential customers in managed-care and similar programs, such as the California Advancing and Innovating Medi-Cal (CalAIM) initiative. As a Managed Care Outreach Coordinator, you will work within the vision, mission, and philosophy of Pacific Clinics, reporting to the CPM or Program Administrator and supporting them in administration functions of the program.

Key Responsibilities
  • Administrative Support: Provides administrative support functions and tasks to ensure programs meet customer, referral, payor, and staff support needs required to meet agency and contract expectations.
  • Shared Services Coordination: Serves as liaison for shared services, coordinating with other departments to meet various reporting and compliance needs.
  • Finance and Billing: Manages authorizations with payors, implements processes with program managers and client services to prevent lapse of authorizations, and consults with finance department and program managers/directors about claims and billing issues and concerns.
  • Quality Assurance: Assists with program audits, customer contact to support clinical program, and supports regional QA for CQI activities and compliance.
Requirements
  • Education: High school diploma or equivalent degree in a related field or equivalent work experience required.
  • Experience: Six (6) months of experience in an administrative position or mental health field required, with one (1) year of experience preferred.
  • Skills: Data management and visualization experience, highly organized and detailed-oriented, flexible and adaptable, analytical ability to analyze detail to inform actions.

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