Community Supports Coordinator, Utilization Management
About The Position
The Community Supports Coordinator, Utilization Management supports members throughout their service journey by monitoring service utilization, coordinating reauthorizations, and helping prevent interruptions in care. The role proactively engages members and caregivers to help ensure authorized services are used effectively and service needs are addressed in a timely manner. The coordinator works with internal operations teams, health plans, Case Managers, and external partners to maintain accurate records, resolve service concerns, and support a positive member experience. This is a hybrid position, with attendance at the El Segundo office once per month. Business hours are 8:00 a.m. to 6:00 p.m. Pacific Time; employees may be scheduled for any shift within those operating hours, depending on the position and business needs.
Requirements
- High school diploma or GED.
- 1–3 years of customer service or related experience.
- Experience managing customer inquiries, service requests, or cases in a high-volume environment.
- Experience using Salesforce or similar CRM or case management systems.
- Skills in utilization monitoring and reauthorization coordination, customer service and member engagement, written and verbal communication, problem solving, attention to detail, organization, time management, and cross-functional collaboration.
Nice To Haves
- Bachelor's degree.
- Bilingual Spanish.
Responsibilities
- Monitor member utilization of authorized services, identify underutilization trends, and conduct proactive outreach to help members maximize available service hours.
- Coordinate reauthorization activities, including tracking authorization expiration dates, gathering required documentation, and following up with health plans and Case Managers.
- Serve as a primary point of contact for members and caregivers, responding to inquiries, addressing service concerns, and supporting continuity of care.
- Collaborate with internal teams, health plans, and external partners to resolve authorization discrepancies, service barriers, and other utilization-related issues.
- Maintain accurate member records, utilization activity, and case documentation in Salesforce while ensuring compliance with established policies and HIPAA requirements.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Education Level
High school or GED
