Job Title: Clinical Support Coordinator 

Shift Timings: 08:00 AM - 05:00 PM PST
Location: Remote in CA
Duration: 3 Months

Summary:
• 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 trainings 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.

Qualifications:
• High school diploma or GED required.
• 2-4 years’ experience required.

Niche Skills – Top 3 Required Skills:

1. Detail-oriented.

2. Excellent written and verbal communication.

3. Experience with data entry and/or utilization management.

- Preferred/Nice-to-Have Skills:

1. Health Plan and/or Medi-Cal experience/knowledge.

2. Experience working in electronic medical record systems.

3. Interest/passion for social services delivery.

Disqualifiers/Dislikes on Resumes:

• N/A. Feedback may be provided during reviews if something presents as a disqualifier.

-Software Skills Required:

• Microsoft Word.

• Microsoft Excel.

• Microsoft Outlook.

• Microsoft Teams.

  
 
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 $21.00/hr - $23.00/hr.