Santa Clara Family Health Plan · 1 month ago
Temp Behavioral Health Personal Care Coordinator
San Jose, CA
Contract
Onsite
Mid Level
$66K/yr - $99K/yr
3+ years expSanta Clara Family Health Plan is seeking a Temp Behavioral Health Personal Care Coordinator. The role involves supporting and coordinating resources for members in case management programs, ensuring compliance with regulatory requirements, and facilitating access to healthcare services.
CommunitiesHealth CareInsurance
Responsibilities
Work with case managers to assist members navigating the healthcare delivery system and home and community-based service to facilitate access related to medical, psychosocial and behavioral health benefits and services
Monitor and respond to inbound case management inquiries and referrals and escalate to clinical staff, as appropriate
Provide outreach to members to facilitate timely completion of Health Risk Assessments (HRA’s) by telephone, mail or in person, as needed
Support the coordination of member care with PCP, Specialists, Behavioral Health and Long Term Services and Supports providers and other stakeholders to assist member to achieve or maintain a level of functional independence which allows them to remain at home or in the community
Assist with coordinating the involvement of the interdisciplinary care team (ICT) members including the member and/or their family/responsible party to implement the individualized care plan (ICP). Oversee correspondence related to care plans. Document ICT meetings following SCFHP policies and procedures
Support successful transition of care for members who move between care settings by coordinating services for medical appointments, pharmacy assistance and by facilitating utilization review. Assist to ensure follow up for psychiatric hospitalizations for members to obtain psychiatric/behavioral health care
Follow UM policies and procedures for new authorization requests. May conduct data entry into the authorization software application system and determination notification to member and/or provider in accordance with regulatory timeframes
Produce and distribute internal reports that may include QI reports, member admission and discharge reports and external stakeholder reports, as appropriate
Follow established Health Services policies and procedures and use available resources to respond to member and/or provider inquiries and resolve any concerns in an accurate, timely, respectful, professional and culturally competent manner
Maintain knowledge of current resources in communities served by our members to support case management goals
Develop effective and professional working relationships with internal and external stakeholders and partners. Communicate effectively with members and providers orally and in writing
May support and conduct non-clinical training in accordance with training guidelines and protocols; provide input and develop training and reference materials. May develop Behavioral Health department orientation binder and assist with onboarding of new employees
Identify issues and trends (data, systems, member, provider, other) as well as general departmental questions/concerns; report relevant information to management; and make recommendations to improve operations
Collaborate with team members on improvement efforts across-departments regarding quality improvement projects, optimization of utilization management, and member satisfaction
Attend and actively participate in daily, weekly, and monthly departmental meetings, in-services, training, coaching sessions and external stakeholder meetings
Understanding of Behavioral Health and 1115 Waiver programs, including Alcohol and Drug Services and assess members for appropriate referrals into these programs. May be required to facilitate Behavioral Health Treatment (BHT) services, including identification of providers, timely access to assessment and treatment
Perform other duties as required or assigned
Qualification
Required
Bachelor's Degree in a health related field or equivalent experience, training or coursework
Minimum three years of relevant experience in a healthcare or community setting providing care coordination of health and/or social services
Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events
Proficient in adapting to changing situations and efficiently alternating focus between telephone and non-telephone tasks to support department operations as dictated by business needs
Ability to consistently meet accuracy and timeline requirements to maintain regulatory compliance
Ability to work within an interdisciplinary team structure
Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific case management programs
Ability to use a keyboard with moderate speed and a high level of accuracy
Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing
Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes
Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position
Ability to maintain confidentiality
Ability to comply with all SCFHP policies and procedures
Ability to perform the job safely and with respect to others, to property and to individual safety
Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time
Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds
Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less
Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment
Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone
Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail
Preferred
Knowledge of Medicare and/or Medi-Cal benefits, community resources and principals of case management
Knowledge of medical terminology
Knowledge of Santa Clara County Health and Social Services
Company
Santa Clara Family Health Plan
Santa Clara Family Health Plan is a local and community-based health plan dedicated to improving the health and well-being of the residents.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Teresa Chapman
Chief People Officer
Recent News
2025-10-30
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