Care Management Specialist
3 days ago
**Overview of Role**
The Blue Shield of California team is seeking a dedicated Clinical Services Coordinator to play a vital role in outreach and engagement efforts with our members. The successful candidate will interact telephonically with members to assist with simple care coordination needs and facilitate connections between members and appropriate services.
**Key Responsibilities**
* Conduct thorough assessments to identify member needs and care gaps
* Maintain accurate and up-to-date member records and documentation of all interactions and services provided
* Provide members with information and resources about available care management services and how to access them
* Assist 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.
* Assist in verifying health plan benefits and coordinating ambulatory services
* Demonstrates cultural competence to work effectively, respectfully, and sensitively within the client's cultural context
**Requirements**
* 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.
* Health insurance/ managed care experience (Commercial, Medicare, and Medi-Cal)
* Community resources and advocacy
* Ability to identify issues and develop effective solutions to meet members' needs
* Flexibility to adjust to changing circumstances and member needs
* Strong verbal and written communication skills to effectively convey information to members and colleagues
**Compensation**
The estimated salary range for this role is $20.47 to $28.66 per hour in California.
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