Job Description The Integrated Duals Program Coordinator II supports care coordination and member engagement activities while serving as an advanced resource across multiple teams. This role ensures timely, effective, and member-centered services through documentation oversight, care coordination support, escalation management, and mentorship of Program Coordinator I staff. The position plays a key role in promoting continuity of care and operational efficiency across the care coordination team. Primary responsibility is supporting the Service Determination/Authorization Team. Work will primarily occur through the client systems (Guiding Care) rather than direct member interaction.

Daily Tasks Include:

Service Determination Review

•  Review completed assessments submitted by field Case Managers
•  Evaluate approved versus requested service hours
•  Determine whether requests require Medical Director review Authorization Processing
•  Create member service authorizations
•  Ensure requests align with assessment findings
•  Process approvals through established workflows Provider Coordination
•  Identify providers capable of servicing approved hours
•  Support provider assignment process
•  Coordinate authorization routing and approvals Member & Provider Notifications
•  Generate and distribute authorization approvals
•  Send required communication to providers and members We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day.

We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

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https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements

•  High school diploma or GED required
•  Positive attitude, quick learner, go getter, great customer service, coachable, adaptability o She is HUGE on personality; she can teach everything
•  Bachelor's degree in a healthcare-related or social science field
•  4+ years of healthcare experience