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Clinical Support Coordinator -87443

El Dorado Hills, CA 95762

Employment Type: Contract Job Number: 9019886 Pay Rate: Pay Rate: $24.18 per hour

Job Description


Community Supports Coordinator
Job Summary

This role supports community services by reviewing screening documents to determine member eligibility, coordinating follow-ups with internal staff and external providers, processing service authorizations, maintaining case records, and ensuring compliance with state and federal regulations.

Responsibilities
  • Review screening documents to determine member eligibility for community supports.
  • Coordinate with internal staff and providers to facilitate referrals and enrollments.
  • Process daily service authorizations and denials for community supports services.
  • Maintain data entry, tracking, and documentation of member status, authorizations, encounters, and regulatory reports.
  • Assist with reconciling provider invoicing and claims.
  • Communicate with providers to ensure timely submission of deliverables and reports.
  • Support the implementation of trainings for internal teams, providers, and community organizations regarding community supports services and referral processes.
  • Identify and address gaps or barriers in care coordination to improve member access to services.
  • Review provider reports for accurate data collection and reporting.
  • Respond to inquiries regarding the status of service authorization requests.
  • Participate in multidisciplinary team meetings to coordinate member care and support retention in services.
  • Conduct outreach calls to members as needed to verify engagement in services.
  • Ensure adherence to all state and federal rules and regulations.
  • Perform other assigned duties as required.

Requirements
  • Strong attention to detail with the ability to maintain accurate case documentation.
  • Proficient in data entry and utilization management processes.
  • Excellent written and verbal communication skills.
  • A demonstrated ability to comply with regulatory requirements and perform under tight deadlines.

Skill
  • Detailed-oriented
  • Excellent written and verbal communication
  • Experience with data entry and/or utilization management

Summary Qualification
  • Health Plan and/or Medi-Cal experience/knowledge
  • Experience working in electronic medical record systems
  • Interest/passion for social services delivery

 

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one’s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one’s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.

 
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About El Dorado Hills, CA

Ready to launch your career in the vibrant El Dorado Hills, California area? Nestled in the picturesque Sierra Nevada Foothills, this region seamlessly blends scenic beauty with flourishing job opportunities. From the captivating views of Folsom Lake and the nearby Eldorado National Forest to the thriving arts scene at the renowned Harris Center for the Arts, there's no shortage of inspiration here. Explore career possibilities in tech companies like Intel, enjoy local delicacies at the El Dorado Hills Town Center, or unwind with a stroll along the historic El Dorado Trail. Embrace the charm and endless potential of El Dorado Hills - your dream job could be just a click away!