Clinical Services Coordinator, Intermediate Position Available In Western Connecticut, Connecticut

Job Description:

Your Role The Behavioral Health Team is responsible thecoordination of care and assistance in finding providers formembers in need. The Clinical Services Coordinator (CSC),Intermediate will report to the Supervisor, Operations -BehavioralHealth . In this role you will be for supporting clinical staffday-to-day operations. Your Work In this role, you will: Work in aproduction-based environment with defined production and qualitymetrics. Process Faxed /Web Portal /Phoned in Authorization orHospital Admission Notification Requests, Utilization Management(UM)/Case Management (CM) requests and/or calls left on voicemail.

The CSC will oversee designated queues and workstreams, withstandardized reports to detect and address member needs. Assists incoordinating care for specific high risk/high-cost patientpopulation, including referrals to community resources,facilitation of medical services, referral to ancillary providers,etc. Provide support to Case Management and/or UtilizationManagement team on member eligibility, benefits, and providernetworks Data entry including authorization forms, high risk memberinformation, verbal HIPPA authorizations information for casecreation. Serves as an initial point of contact for providersand/or members in the behavioral health management process bytelephone or correspondence. Assists with system letters, requestsfor information and data entry. Provides administrative/clericalsupport to Behavioral Health management. Your Knowledge andExperience Requires a high school diploma or equivalent Requires atleast 3 years of prior relevant experience Desired certificationand/or training as a patient advocate, health coach, care navigatoror other relevant health plan experience 2-year work experiencewith managed health care utilization or case management departmentor a similar medical management department at a different payor,facility, or provider/group. Ability to work in a high-pacedproduction environment with occasional overtime needed (includingweekends) to ensure regulatory turnaround standards are met.

Knowledge of clinical workflow to assist BH Care Managers with casecreation, research/issue resolution and other UM related functions,as necessary.