Your Role

The Care Management Department is seeking a dedicated and compassionate Clinical Service Coordinator (CSC) to join our team.  The Clinical Service Coordinator will report to the Supervisor of Care Operations. The CSC will play a vital role in outreach and engagement efforts with our members, introducing them to care management services, and conducting assessments to identify their needs. The successful candidate will interact telephonically with members to assist with simple care coordination needs and facilitate connections between members and appropriate services, including internal nurse care managers, vendors, and behavioral health providers. 

Your Work

In this role, you will:

• Conduct telephonic outreach efforts to engage members and introduce them to care management services
• Complete thorough assessments to identify member needs and care gaps
• Maintain accurate and up-to-date member records and documentation of all interactions and services provided
• Conduct follow-up calls to ensure members’ needs are being met
• Provide members with information and resources about available care management services and how to access them 
• Provides administrative/clerical support to medical and disease management programs
• Acts as a liaison, gathers information, and track all patients referred to the care management programs
• 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.
• Assists in verifying health plan benefits and coordinating ambulatory services
• Demonstrates cultural competence to work effectively, respectfully, and sensitively within the client’s cultural context
• Assists with precepting responsibilities for new hires and auditing effort
• Must be able to work 1-2 rotating Saturdays per month

Your Knowledge and Experience

• A minimum of a high school diploma
• A minimum of 3 years of relevant experience
• A minimum of 1 year experience in a managed care environment. 
• Health insurance/ managed care experience (Commercial, Medicare, and Medi-Cal)
• Community resources and advocacy
• Ability to identify issues and develop effective solutions to meet members' needs
• Flexibility to adjust to changing circumstances and member needs 
• Strong verbal and written communication skills to effectively convey information to members and colleagues

Pay Range: 

The pay range for this role is: $ 20.47 to $ 28.66 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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