Clinical Support Coordinator 2
Spectraforce
Rancho Cordova, California
2 days ago
Job Description
Clinical Support Coordinator 2
Remote
6+ Months
Day to Day 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 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.
Required Skills (top 3 non-negotiables):
1. Detailed-oriented
2. Excellent written and verbal communication
3. Experience with data entry and/or utilization management
Preferred Skills (nice to have):
1. Health Plan and/or Medi-Cal experience/knowledge
2. Experience working in electronic medical record systems
3. Interest/passion for social services delivery
Education Requirements: High School Diploma or equivalent
Software Skills Required: Word, Excel, Outlook, Teams
About Us: SPECTRAFORCE is one of the fastest-growing workforce solutions firms in the United States. As a diversity-owned business, we place human connection at the heart of everything we do, building strong relationships with both clients and candidates to fill roles successfully. Our teams in North and Central America and India serve more than 150 Fortune clients globally, leveraging custom AI technology to provide direct hire, executive search, nearshoring, offshoring, and project staffing solutions.
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.
Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.
California Applicant Notice: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.
LA County, CA Applicant Notice: If you are selected for this position with SPECTRAFORCE, your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer.
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 starting pay is: $20.00/hr.
Remote
6+ Months
Day to Day 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 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.
Required Skills (top 3 non-negotiables):
1. Detailed-oriented
2. Excellent written and verbal communication
3. Experience with data entry and/or utilization management
Preferred Skills (nice to have):
1. Health Plan and/or Medi-Cal experience/knowledge
2. Experience working in electronic medical record systems
3. Interest/passion for social services delivery
Education Requirements: High School Diploma or equivalent
Software Skills Required: Word, Excel, Outlook, Teams
About Us: SPECTRAFORCE is one of the fastest-growing workforce solutions firms in the United States. As a diversity-owned business, we place human connection at the heart of everything we do, building strong relationships with both clients and candidates to fill roles successfully. Our teams in North and Central America and India serve more than 150 Fortune clients globally, leveraging custom AI technology to provide direct hire, executive search, nearshoring, offshoring, and project staffing solutions.
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.
Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.
California Applicant Notice: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.
LA County, CA Applicant Notice: If you are selected for this position with SPECTRAFORCE, your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer.
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 starting pay is: $20.00/hr.