Clinical Services Coordinator, Intermediate (Bilingual)
About The Position
Your Role The Clinical Services Coordinator (CSC) Bilingual will serve as an initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that members are effectively and efficiently managed through the medical/disease management process as needs require and in helping the RN care manager or social worker in arranging appropriate medical equipment (DME), home health, follow-up appointments, and other services related to care coordination. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Requirements
- Requires a high school diploma or equivalent
- Requires at least 3 years of prior relevant experience
- Bilingual English to Spanish is required
- Experience with health insurance/ managed care (Commercial, Medicare, and Medi-Cal) and community resources and advocacy
- Ability to identify issues and develop effective solutions to meet members' needs
- Available to work a scheduled 8-hour shift, which includes 2 scheduled breaks and a lunch period, M-F between 8am and 7pm.
- Available to work occasional weekends as part of a quarterly rotation.
- Flexibility to adjust to changing circumstances and member needs
- Strong verbal and written communication skills to effectively convey information to members and colleagues
Responsibilities
- Telephonic outreach to conduct the Health Risk Assessment (HRA) with members
- Telephonic outreach to members as directed by protocol or RN Care Manager or Social Worker
- Assists with system letters, requests for information and data entry
- Assists in translation (Spanish to English)
- Provides administrative/clerical support to medical and disease management programs
- Acts as a liaison, gathers information, and tracks all patients referred to the care management programs
- Assists 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.
- Documents all patient specific information in appropriate information systems
- Assists in verifying health plan benefits and coordinating ambulatory services
- Demonstrates cultural competence to work effectively, respectfully, and sensitively within the client’s cultural context
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
