Clinical Services Coordinator, Intermediate
Company: Blue Shield of California
Location: Stockton
Posted on: June 24, 2025
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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 will report to the Supervisor, Operations -Behavioral
Health . In this role you will be for supporting clinical staff
day-to-day operations. Your Work In this role, you will: Work in a
production-based environment with defined production and quality
metrics. Process Faxed /Web Portal /Phoned in Authorization or
Hospital Admission Notification Requests, Utilization Management
(UM)/Case Management (CM) requests and/or calls left on voicemail.
The CSC will 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
networks Data entry including authorization forms, high risk member
information, verbal HIPPA authorizations information for case
creation. Serves as an initial point of contact for providers
and/or members in the behavioral health management process by
telephone or correspondence. Assists with system letters, requests
for information and data entry. Provides administrative/clerical
support to Behavioral Health management. Your Knowledge and
Experience Requires a high school diploma or equivalent Requires at
least 3 years of prior relevant experience Desired certification
and/or training as a patient advocate, health coach, care navigator
or other relevant health plan experience 2-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.
Keywords: Blue Shield of California, Berkeley , Clinical Services Coordinator, Intermediate, Healthcare , Stockton, California
