Care Coordination Specialist
About The Position
We are seeking a Care Coordination Specialist to support critical functions within our Care Coordination Department, including utilization management, case management, and the grievance and appeals process. This role plays an important part in ensuring that clinical and administrative decisions are accurate, well‑documented, and completed in accordance with regulatory and organizational standards. The Care Coordination Specialist assists with the collection and analysis of clinical and non‑clinical information, maintains detailed documentation related to complex determinations, and collaborates with internal teams, providers, and members to facilitate timely resolutions. This position also supports quality improvement initiatives and organizational readiness for accreditation reviews and regulatory audits.
Requirements
- Associate's degree from an accredited two‑year college or technical school, or an equivalent combination of education and experience
- Six months to one year of related experience; healthcare or clinical environment experience preferred
- Strong analytical and problem‑solving skills, with the ability to research and interpret clinical, benefit, and regulatory information
- Excellent written and verbal communication skills, including the ability to prepare reports and present information to leadership or cross‑functional teams
- Proficiency with Microsoft Office applications and electronic documentation systems
Nice To Haves
- Two or more years of relevant experience in a clinical or healthcare setting
- Experience supporting utilization management, case management, grievances, appeals, or quality‑related processes
- Familiarity with healthcare regulations, accreditation standards, and audit readiness activities
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
