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 ensure authorized services are used effectively and service needs are addressed promptly. The coordinator works closely 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. Standard business hours are 8:00 a.m. to 6:00 p.m. Pacific Time, but the position includes scheduled coverage through 8:00 p.m. and weekend shifts. Available schedules are Sunday 8:00 a.m.–5:00 p.m. and Monday–Thursday 12:00 p.m.–8:00 p.m., or Tuesday–Friday 12:00 p.m.–8:00 p.m. and Saturday 8:00 a.m.–5:00 p.m.
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.
Nice To Haves
- Bachelor's degree.
- Bilingual Spanish.
Responsibilities
- Monitor members’ use of authorized services, identify underutilization trends, and conduct proactive outreach to help members maximize available service hours.
- Coordinate reauthorization activities by 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, respond to inquiries, address service concerns, and support 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 complying with established policies and HIPAA requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
