Sr. Care Coordinator (Behavioral Health)

SCAN Health Plan•Long Beach, CA

17d•Remote

About The Position

The Sr. Care Coordinator (Behavioral Health) contributes to the care and well-being of SCAN members, helping them age in place by collaboratively assessing, planning, coordinating, and monitoring holistic needs, including behavioral health and psychosocial needs. The role provides guidance and care coordination to reduce barriers to care, improve engagement, and support continuity across behavioral health and medical services. It focuses on coordinating care, processing referrals and services, connecting members with appropriate resources, supporting healthcare-system navigation, and compassionately resolving escalated issues. The position conducts general and behavioral health screenings and makes appropriate referrals; connects members with behavioral health services and social supports; and helps members and caregivers understand care options. It coordinates with members, providers, medical groups, care teams, and internal and external departments to develop action plans, address access and authorization barriers, and support continuity of care. The role also assists with provider availability and appointment scheduling, follows up after initial appointments, and facilitates communication among members and care partners. The Sr. Care Coordinator maintains timely, accurate documentation across multiple systems, including the EMR and tracking database. The role handles complex issues with minimal supervision, serves as a subject matter expert, supports team members, contributes to special projects, and may serve as a liaison with behavioral health providers. It may also help develop procedures, workflows, job aids, and training materials, and identify process barriers and potential improvements. This is a remote position working 8 a.m.–5 p.m. Pacific Time, Monday through Friday. A background check is required.

Requirements

High school diploma required.
At least 5 years of experience working in managed care, a healthcare environment, or behavioral health case management.
Advanced technical skills for the functional area.
Basic problem-solving skills.
Good communication and interpersonal skills.
Ability to use advanced motivational interviewing techniques, including de-escalation, to understand and address member concerns.
Ability to work in an environment where continuous coaching and feedback are standard practice.
Ability to proactively seek answers, work independently, and serve as a subject matter expert in troubleshooting member issues.
Strong written and verbal communication skills.
Strong organizational and critical-thinking skills.
Ability to collaborate effectively within a multidisciplinary team and with provider partners.
Ability to maintain confidentiality appropriately.
Strong knowledge of medical terminology and abbreviations.
Deep understanding of CMS and DHCS regulations, including Special Needs Plan requirements.
Deep understanding of local community resources for seniors.

Nice To Haves

Some college preferred.
At least 2 years of experience working with seniors and working remotely strongly preferred.
Bilingual Spanish strongly preferred, including conversational speaking, reading, and writing; testing may be administered if applicable.

Responsibilities

Conduct general and behavioral health screenings and complete initial screening promptly after receiving a new referral.
Participate in special projects while balancing competing priorities, and/or serve as a SCAN liaison with behavioral health providers.
Serve as a point of contact for members, providers, and medical groups regarding benefits and programs, including exploring behavioral health provider preferences with members and care teams.
Connect members to appropriate behavioral health services and social support, and troubleshoot complex psychosocial concerns and escalated access issues.
Use advanced motivational interviewing and de-escalation techniques to understand member goals and concerns, improve engagement, and minimize conflict and grievances.
Educate members and caregivers about behavioral health care journeys and available options to support informed decisions and follow-through.
Coordinate care using knowledge of member benefits, internal and external partners, and community resources; develop action plans and resolve access-to-care issues.
Contact behavioral health providers to identify appointment availability, assist with scheduling as needed, and follow up after the first appointment to confirm needs and continuity of care.
Facilitate communication among members, providers, and care teams to ensure coordinated care.
Complete timely and accurate screenings, care plans, service plans, case notes, service requests, and behavioral health navigation documentation in multiple systems.
Document interactions, progress, and outcomes in the EMR and tracking database within established timeframes and according to department procedures.
Use organizational, analytical, critical-thinking, and leadership skills to resolve issues and assist team members and partners.
Educate network providers on contract requirements and their ability to serve SCAN members; collaborate to resolve authorization and contract barriers affecting timely access.
Handle sensitive behavioral health concerns professionally and empathetically, de-escalating tense situations to support timely resolution and a positive member experience.
Use and assist in developing department procedures, workflows, job aids, and training materials related to behavioral health navigation, referral tracking, and access-to-care processes.
Identify workflow barriers and bring potential solutions or revisions to the supervisor or manager.
Serve as a subject matter expert on team processes for the team and other teams; handle complex issues with minimal supervision and refer only the most complex issues to higher-level staff.
Actively support SCAN’s Vision and Goals and perform other duties as assigned.