Job Description

Your Role The Behavioral Health Team is responsible the coordination of care and assistance in finding providers for members in need. The Clinical Services Coordinator (CSC)- Intermediate (Appointment Assistance) will report to the Supervisor, Operations -Behavioral Health. In this role you will be for supporting clinical staff day-to-day operations.Your WorkIn this role, you will:Serve as a primary point of contact for members by providing support via inbound and outbound phone interactionsConduct outreach to healthcare providers and programs to obtain information on services and appointment availability, coordinate appointments, and ensure continuity of care. Work in a production-based environment with defined production and quality metrics.Oversee designated queues and workstreams, with standardized reports to detect and address member needs.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.Provide support to Case Management and/or Utilization Management team on member eligibility, benefits, and provider network availability.Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation.Provides administrative/clerical support to Behavioral Health management.Your Knowledge and Experience Requires a high school diploma or equivalentRequires at least 3 years of prior relevant experienceDesired certification and/or training as a patient advocate, health coach, care navigator or other relevant health plan experience2-year work experience with managed health care utilization or case management department or a similar medical management department at a different payor, facility, or provider/group.Ability to work in a high-paced production environment with occasional overtime needed (including weekends) to ensure regulatory turnaround standards are met. Knowledge of clinical workflow to assist BH Care Managers with case creation, research/issue resolution and other UM related functions, as necessary.

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