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Blue Shield of California · 9 hours ago

Clinical Services Coordinator, Intermediate

El Dorado Hills, CA, United States

Full-time

Hybrid

Mid Level

$21.73/hr - $30.43/hr

3+ years exp

Blue Shield of California is a nonprofit healthcare organization committed to transforming healthcare for its members. The Clinical Services Coordinator will assist members and their families in accessing and managing behavioral health treatment services, ensuring effective communication and support throughout the process.

Financial ServicesHealth InsuranceNon Profit

No H1B

Responsibilities

Process faxed/phoned in authorization requests, UM/CM requests and/or calls left on voicemail

Select support for Case Manager such as mailings, surveys

Data entry including authorization forms, high risk member information, verbal HIPPA authorizations, information for case creation, in consultation with the Board-Certified Behavior Analyst (BCBA)

Support to Advanced/Specialist CSC

Respond to inquiry calls as needed

Assign initial EOA days, or triage to clinicians, based on established workflow

Research member eligibility/benefits and provider networks

Be responsible for establishing trusting relationships with members while providing person-centered support and services

Provide members and/or family members with care coordination, generate referrals to contracted ancillary service providers and community agencies in collaboration with the member’s provider

Document assessments, referrals, and case notes in the electronic case management and tracking systems within the established department guidelines

Provide telephonic triage and care management assistance to members seeking access to the Behavioral Health Therapy (BHT) benefit

Follow up efficiently with PCP offices to obtain necessary documents

Other duties as assigned

Qualification

Behavioral Health TreatmentData EntryCare CoordinationDatabase ManagementCommunication SkillsHigh School DiplomaTeam Collaboration

Required

Requires at least 3 years of prior relevant experience

Requires a High School diploma or equivalent

Ability to enter data into the computer and extract information from databases required

Excellent communication skills with individuals internal and external to BSC including physicians, members, patients, and service providers required

Ability to assist the member, family and/or caregiver, and provider in the treatment and management of BHT services, in consultation with the Board-Certified Behavior Analyst (BCBA) required