Clinical Coordinator

Brighton Health Plan Solutions • Chapel Hill, NC

8d

About The Position

The Clinical Coordinator plays a key role within Brighton Health Plan Solutions’ Case Management / Medical Management team. This position supports case management activities through member outreach, clinical intake, data collection, and accurate information entry. The Clinical Coordinator ensures seamless communication between members, providers, and Nurse Case Managers while adhering to departmental workflows and quality standards.

Requirements

• High school diploma or GED.
• Strong skills in reviewing medical records and clinical information.
• Excellent customer service and written/verbal communication skills.
• Ability to think critically, gather data, and identify facts.
• Proficiency with PC systems, including Microsoft Word and Excel.
• Strong data entry accuracy and attention to detail.
• Ability to work independently, manage tasks, and demonstrate strong organizational skills.
• Ability to work flexible hours, including availability after 5 p.m. as needed.

Nice To Haves

• Bachelor’s degree.
• Familiarity with medical terminology.
• Experience working in a database environment.
• Previous customer service or medical office experience.
• Demonstrated ability to learn new software programs.

Responsibilities

• Conduct proactive outreach to engage members in case management programs.
• Answer and manage incoming calls within established performance timeframes.
• Send correspondence, resources, and educational materials to members via mail or email.
• Collect clinical and demographic information from members, representatives, and providers; verify eligibility as needed.
• Create and update cases within the Case Management system in accordance with departmental policies and workflows.
• Conduct initial clinical intake assessments to determine acuity and routing needs; escalate to RN Case Managers when appropriate.
• Communicate effectively with members and healthcare providers to gather and relay clinical information regarding diagnoses, medical status, and care needs.
• Maintain accurate documentation, adhering to BHPS policies, procedures, and quality assurance standards.
• Identify and communicate concerns, complaints, or issues to the direct supervisor promptly.
• Demonstrate Brighton’s core values through professionalism, empathy, and a positive, customer‑focused approach.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees