Job Title: Clinical Care Coordinator

Location: Remote

Work Hours: 8:30 AM – 5:00 PM (40 hours per week)

Duration: 6 Months (Potential to Extend)

Position Summary: We are seeking a detail-oriented and proactive individual to join our team as a Clinical Care Coordinator. In this role, you will review eligibility, process service authorizations, support the referral and enrollment process, and ensure accurate data tracking and

documentation related to CalAIM Community Supports services. This position will also involve ongoing communication with internal teams and external providers to ensure members are enrolled and receiving the services they need.

Day-to-Day Responsibilities:

• Eligibility & Enrollment Support: Review CalAIM Community Supports Screening documents to determine eligibility and assist with the referral and enrollment process.
• Service Authorization & Denials: Process daily service authorizations and denials for requested services.
• Data Management: Perform data entry, tracking, and case documentation for all members referred for services, including enrollment status, authorizations, encounter data, care coordination activities, and regulatory reports.
• Provider Support: Assist with reconciling provider invoicing and claims. Ensure timely submission of deliverables and reports from Community Supports Providers.
• Training & Education: Support the implementation of training for internal teams, external providers, and community-based organizations on CalAIM Community Supports services and referral processes.
• Gap Identification: Identify and help address barriers in the care coordination process to improve member access to services.
• Provider Reporting: Review provider reports to ensure data collection accuracy and compliance.
• Member Engagement: Conduct outreach calls to verify member engagement and respond to inquiries regarding service authorization request status.
• Compliance: Ensure compliance with state and federal rules and regulations.
• Collaboration: Participate actively in multidisciplinary team meetings and member care coordination.
• Other Duties: Perform other duties as required.

Required Skills:

1. Medical administrative experience: One year minimum
2. Detail-Oriented: Strong attention to detail in handling eligibility, data entry, and case documentation.
3. Communication: Excellent written and verbal communication skills.
4. Data Entry/Utilization Management: Experience in data entry and/or utilization management.

Preferred Skills:

1. Health Plan/Medi-Cal Experience: Knowledge of or experience with Health Plans and/or Medi-Cal programs.
2. EMR Systems Experience: Experience working in electronic medical record systems.
3. Social Services Interest: A passion for or interest in social services delivery.

Education Requirements:

• High School Diploma or equivalent.

Software Skills Required:

• Proficiency in Microsoft Word, Excel, Outlook, and Teams.

Pay and Benefits

The pay range for this position is $19.00 - $21.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Feb 8, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $19 - $21