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Clinical Support Specialist

$19 - $20 per hour

SPECTRAFORCE

1 week ago Be among the first 25 applicants

This range is provided by SPECTRAFORCE. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$19.00/hr - $20.00/hr

Direct message the job poster from SPECTRAFORCE

Senior Recruiter at SPECTRAFORCE Technologies

Job Title: Clinical Support Coordinator 2

Location: Remote in California

Duration of the assignment: 6+ Months (Potential to extend or convert to a permanent role depending on the performance and business needs)

Shift timings: 8:30AM- 5:00PM Pacific Times.

The pay rate starts from $20/hour

Day to Day Responsibilities

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

Required Skills (top 3 non-negotiables):

  • Detailed-oriented
  • Experience with data entry and/or utilization management

Preferred Skills (nice to have):

  • Health Plan and/or Medi-Cal experience/knowledge
  • Experience working in electronic medical record systems

Education Requirements: High School Diploma or equivalent

Software Skills Required: Word, Excel, Outlook, Teams

Seniority level
  • Seniority level
    Entry level
Employment type
  • Employment type
    Full-time
Job function
  • Job function
    Administrative
  • Industries
    Pharmaceutical Manufacturing, Hospitals, and Hospitals and Health Care

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