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Clinical Services Coordinator
2 months ago
The Clinical Services Coordinator, Intermediate, plays a vital role in the medical management process at Blue Shield of California. As the initial point of contact for providers and members, this position requires strong communication and interpersonal skills to ensure effective and efficient management of member care.
Key Responsibilities- Telephonic Outreach: Conduct Health Risk Assessments (HRAs) with members and provide telephonic support as directed by protocol or RN care manager or social worker.
- Administrative Support: Assist with system letters, requests for information, and data entry, as well as provide backup support for phones when needed.
- Care Coordination: Act as a liaison to gather information and track patients referred to care management programs, and assist in coordinating care for high-risk/high-cost patient populations.
- Documentation: Document all patient-specific information in appropriate information systems.
- Benefits Verification: Assist in verifying health plan benefits and coordinating ambulatory services.
- Cultural Competence: Demonstrate cultural competence to work effectively, respectfully, and sensitively within the client's cultural context.
- Precepting and Auditing: Assist with precepting responsibilities for new hires and auditing efforts.
- Education: A minimum of a high school diploma is preferred, and a minimum of 3 years of experience is typically required. Vocational or technical education in addition to prior work experience may be beneficial.
- Experience: A minimum of 1 year of experience in a managed care environment is preferred, and bi-lingual in Spanish is required. Health insurance/managed care experience (Commercial, Medicare, and Medi-Cal) and community resources and advocacy experience are also preferred.
- Skills: Basic job knowledge of systems and procedures, strong communication and interpersonal skills, and the ability to work effectively in a team environment.
The pay range for this role is $20.47 to $28.66 for California. Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade.
