Clinical Services Coordinator, Advanced

California Physicians' Service • Long Beach, CA

416d

About The Position

The Clinical Services Coordinator (CSC) plays a crucial role in the medical management process by serving as the initial point of contact for providers and members. This position involves telephonic outreach to members, assisting with care coordination, and providing administrative support to ensure effective management of health services. The CSC collaborates with RN care managers and social workers to facilitate necessary medical services and resources for members, particularly those in high-risk categories.

Requirements

• High school diploma or equivalent required.
• Minimum of 5 years relevant experience required.
• Minimum of 3 years combined experience in a clinical practice in a hospital, outpatient, health plan, community health, or care management setting preferred.
• Bilingual preferred.

Responsibilities

• Conduct telephonic outreach to perform Health Risk Assessments (HRA) with members.
• Assist members as directed by protocol or RN care manager or social worker.
• Support with system letters, requests for information, and data entry.
• Provide backup support for phones when needed.
• Offer administrative and clerical support to medical and disease management programs.
• Act as a liaison, gather information, and track all patients referred to care management programs.
• Coordinate care for high-risk/high-cost patient populations, including referrals to community resources and ancillary providers.
• Document all patient-specific information in appropriate information systems.
• Verify health plan benefits and coordinate ambulatory services.
• Demonstrate cultural competence in working with clients from diverse backgrounds.
• Assist with precepting responsibilities for new hires and auditing efforts.

What This Job Offers

• Job Type: Full-time
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED