Intermediate Clinical Services Coordinator
- Blue Shield of California
- | Drytown, CA
$17.33 per hour |
OTHER |
July 22nd, 2025
-
Blue Shield of California -
Drytown, CA
-
$17.33 per hour
-
OTHER
-
July 22nd, 2025
Your Role
The Behavioral Health Team is responsible the coordination of care and assistance in finding providers for members in need. The Clinical Services Coordinator (CSC)- Intermediate (Appointment Assistance) will report to the Supervisor, Operations -Behavioral Health. In this role you will be for supporting clinical staff day-to-day operations.
Your Work
In this role, you will:
- Serve as a primary point of contact for members by providing support via inbound and outbound phone interactions
- Conduct outreach to healthcare providers and programs to obtain information on services and appointment availability, coordinate appointments, and ensure continuity of care.
- Work in a production-based environment with defined production and quality metrics.
- Oversee designated queues and workstreams, with standardized reports to detect and address member needs.
- Assists in coordinating care for specific high risk/high-cost patient population, including referrals to community resources, facilitation of medical services, referral to ancillary providers, etc.
- Provide support to Case Management and/or Utilization Management team on member eligibility, benefits, and provider network availability.
- Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation.
- Provides administrative/clerical support to Behavioral Health management.
Your Knowledge and Experience
- Requires a high school diploma or equivalent
- Requires at least 3 years of prior relevant experience
- Desired certification and/or training as a patient advocate, health coach, care navigator or other relevant health plan experience
- 2-year work experience with managed health care utilization or case management department or a similar medical management department at a different payor, facility, or provider/group.
- Ability to work in a high-paced production environment with occasional overtime needed (including weekends) to ensure regulatory turnaround standards are met.
- Knowledge of clinical workflow to assist BH Care Managers with case creation, research/issue resolution and other UM related functions, as necessary.
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