Medical Management Care Coordinator

Location: San Jose, CA

Schedule: Monday-Friday | 8:00 AM-5:00 PM

Pay: $26-$30/hour

About the Role

We are seeking a Medical Management Care Coordinator to support members enrolled in care management programs and help ensure they receive the services and resources needed to achieve positive health outcomes.

In this role, you will work closely with case managers, healthcare providers, community organizations, and members to coordinate care, support transitions between care settings, and assist individuals navigating the healthcare system.

Key Responsibilities

• Partner with case managers to support members accessing healthcare and community-based services
• Monitor and respond to case management referrals and inquiries, escalating to clinical staff when appropriate
• Conduct member outreach to support completion of Health Risk Assessments (HRAs)
• Coordinate care activities with primary care providers, specialists, behavioral health providers, and long-term services and supports
• Support interdisciplinary care teams and individualized care planning
• Assist with transitions of care between healthcare settings
• Process authorization requests and notifications in accordance with utilization management policies
• Prepare and distribute reports related to quality initiatives, admissions, discharges, and care management activities
• Respond to member and provider inquiries in a professional and timely manner
• Maintain knowledge of community resources and available support programs
• Build strong relationships with internal teams, providers, and community partners
• Support training initiatives and develop reference materials as needed
• Identify operational issues and recommend process improvements
• Participate in quality improvement, utilization management, and member satisfaction initiatives
• Attend department meetings, training sessions, and team development activities
• Perform additional duties as assigned

Qualifications

• Bachelor's degree in a health-related field or equivalent combination of education and experience
• Minimum 3 years of experience in healthcare, case management, care coordination, social services, or a related field
• Valid California driver's license or ability to use alternative transportation
• Strong organizational, communication, and customer service skills
• Ability to manage multiple priorities and meet established deadlines
• Experience working within interdisciplinary care teams
• Proficiency with Microsoft Outlook, Word, Excel, and case management software
• Strong attention to detail and commitment to confidentiality
• Ability to adapt in a fast-paced environment and balance phone and administrative responsibilities

Preferred Qualifications

• Knowledge of Medicare and/or Medi-Cal programs
• Understanding of case management principles and community resource navigation
• Familiarity with medical terminology
• Knowledge of Santa Clara County health and social service resources
• Bilingual in Spanish, Vietnamese, Chinese, or Tagalog

Compensation & Benefits

• $26-$30/hour, based on experience and qualifications
• Comprehensive benefits package available
• Opportunity to make a meaningful impact on member health outcomes
• Collaborative and mission-driven work environment

Apply Today

If you are passionate about helping individuals access healthcare services, navigate community resources, and improve their overall well-being, we encourage you to apply. Join a team dedicated to delivering exceptional member support throughout the San Jose community.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.