Clinical Support Coordinator

Payrate: $20.00 - $22.00/hr
 
Responsibilities:

• Review Community Supports Screening documents to determine member eligibility for Community Supports.
• Follow up with internal staff and providers to support the successful referral and enrollment of members into 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  Community Supports trainings to internal teams, external providers, and community-based organizations by providing ongoing education about 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 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.

 
Software Skills Required:

• Word
• Excel
• Outlook
• Teams

 
Preferred/nice to have skills

• Health Plan experience/knowledge
• Experience working in electronic medical record systems
• Interest/passion for social services delivery

 
Pay Transparency: The typical base pay for this role across the U.S. is: $20.00 - $22.00/hr. Non-exempt positions are eligible for overtime at a rate of 1.5 times the base hourly rate for all hours worked in excess of 40 in a work week, or as required by state or local law. Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education and experience. Full-time employees are eligible to select from different benefits packages. Packages may include medical, dental, and vision benefits, health savings accounts with qualified medical plan enrollment, 10 paid days off, 3 days paid bereavement leave, 401(k) plan participation with employer match, life and disability insurance, commuter benefits, dependent care flexible spending account, accident insurance, critical illness insurance, hospital indemnity insurance, accommodations and reimbursement for work travel, and discretionary performance or recognition bonus. Sick leave and mobile phone reimbursement provided based on state or local law. 

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