Clinical Support Coordinator 2

Spectraforce

Rancho Cordova, California


2 hours ago

Remote

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Job Description

Job Title: Clinical Support Coordinator 2
Location: Remote
Assignment Duration: 6+ Months (poteintial of extension)
Shift- Standard shift 

Position Summary
The Clinical Support Coordinator 2 will support CalAIM Community Supports activities, including member eligibility screening, referrals and enrollment, service authorizations, data entry, case documentation, provider coordination, and member outreach.

Key Responsibilities

  • Review CalAIM Community Supports Screening documents to determine member eligibility for CalAIM Community Supports.
  • Follow up with internal staff and providers to support the successful referral and enrollment of members into CalAIM Community Supports services.
  • Process daily service authorizations and denials for requested Community Supports services.
  • Perform data entry, tracking, and case documentation for all members referred for services, including enrollment status, authorizations, encounter data, care coordination activities, clinical case records, and regulatory reports.
  • Support with reconciling provider invoicing and claims.
  • Support with sending communications to Community Supports Providers to ensure timely submission of deliverables and reports.
  • Support with implementation of CalAIM Community Supports training to internal teams, external providers, and community-based organizations by providing ongoing education about CalAIM Community Supports services and referral process.
  • Identify and help to address gaps/barriers in the care coordination process to improve member access to services.
  • Review Provider reports to ensure accurate data collection and reporting.
  • Respond to inquiries regarding service authorization request status.
  • Actively participate in Multidisciplinary Team meetings to coordinate member care and support member retention in CalAIM Community Supports services.
  • Conduct outreach calls to members, as needed, to verify engagement in Community Supports services.
  • Participate actively in ensuring that all state and federal rules and regulations are followed.
  • Perform other assigned duties, as required.

Required Skills

  • Detailed-oriented.
  • Experience working in electronic medical record systems.
  • Experience with data entry and/or utilization management.

Preferred Skills

  • Health Plan and/or Medi-Cal experience/knowledge.
  • Excellent written and verbal communication.
  • Interest/passion for social services delivery.

Education

  • High School Diploma or equivalent.

Software Skills Required

  • Word
  • Excel
  • Outlook
  • Teams
 
Applicant Notices & Disclaimers
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At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position's pay range is $22.00/hr - $26.00/hr.