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Clinical Services Coordinator, Intermediate

Blue Shield of California

North Highlands, CA
15 days ago

Job Description

Join Blue Shield of California as a Clinical Services Coordinator, Intermediate, where you will support clinical staff in coordinating care for members. You'll manage authorization requests, oversee member needs, and provide essential administrative support, all while working in a dynamic, production-based environment.

Key Responsibilities

  • Coordinate care for high risk/high-cost patient populations
  • Process authorization requests and utilization management calls
  • Oversee designated queues and workstreams for member needs
  • Provide support to case management and utilization management teams
  • Perform data entry for authorization forms and high-risk member information
  • Serve as initial contact for providers and members in behavioral health management
  • Assist with administrative support to Behavioral Health management

Required Qualifications

  • High school diploma or equivalent
  • At least 3 years of prior relevant experience
  • Ability to work in a high-paced production environment

Preferred Qualifications

  • Certification as a patient advocate, health coach, care navigator
  • 2-year work experience with managed health care utilization or case management