Case Management Coordinator I Medica Talent Group Montebello, CA Job Details Temporary | Full-time $24 - $26 an hour 3 hours ago Qualifications Spanish Teamwork Medicare Commercial insurance knowledge EHR systems Employee relationship building Clinic experience Overseeing health insurance pre-authorization High school diploma or GED Medicaid health insurance ICD-10 Medicare regulations Medicaid regulations Medicaid Medical terminology Stakeholder relationship building Time management Full Job Description

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TEMPORARY ASSIGNMENT UNTIL 11/2026

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Job Summary:

Supports care coordination and case management activities for an identified member population. Gathers and documents relevant member information throughout assessment, care planning, interdisciplinary care team meetings, and transitions of care. Provides low-risk problem solving and care coordination in collaboration with Case Managers. Serves as a liaison between members, providers, specialists, and community resources to help ensure members receive appropriate services.

Key Responsibilities:

Enter and maintain accurate member information in the case management system to support timely care coordination and outreach. Verify member benefits and eligibility when care coordination or case management services are received. Utilize DOFR (Division of Financial Responsibility) and delegation agreements to support appropriate decision-making.

Coordinate and assist with:

Patient appointments Transportation services Community and social service resources Gather relevant clinical and member information for: Assessments Care planning Interdisciplinary Team (IDT) meetings Transitions of care Complete applicable patient assessments and document findings accurately. Perform low-risk problem solving and coordination activities in collaboration with Case Managers. Conduct member outreach to verify needs are being addressed and services are being delivered. Coordinate the delivery of direct services to members and their families. Communicate and coordinate with Primary Care Providers and Specialists. Collaborate with interdisciplinary teams and facilitate effective communication between care team members. Process required Model of Care elements within established departmental timelines and targets. Maintain required caseload levels and meet productivity expectations. Meet established audit standards and minimum quality scores for core responsibilities. Perform additional duties and responsibilities as assigned.

Required Qualifications:

High School Diploma or equivalent required. Minimum of 1 year of experience working in a healthcare environment . Prior experience working in a clinic, healthcare call center, or similar healthcare setting . Knowledge of prior authorization and case management regulations related to: Medi-Cal Medicare Commercial insurance CCS Other government and commercial healthcare programs

Preferred Qualifications:

Experience working in a managed care environment , preferably an IPA, HMO, or health plan. Experience working with a diverse patient/member population. Bilingual English/Spanish strongly preferred.

Skills & Abilities:

Knowledge of medical terminology and medical coding, including ICD-10, CPT, and HCPCS . Understanding of the healthcare industry, preferably managed care. Proficiency with computers, including: Word processing applications Authorization/case management systems Microsoft Excel or similar spreadsheet programs Knowledge of HIPAA guidelines and Protected Health Information (PHI) privacy requirements . Exceptional organizational and time-management skills. Strong verbal and written communication skills. Excellent interpersonal and relationship-building skills. Ability to effectively communicate and collaborate with members, families, providers, and interdisciplinary care teams.

Pay:

$24.00 - $26.00 per hour

Education:

High school or equivalent (Required)

Experience:

EHR systems: 1 year (Preferred)

Prior Authorization :

1 year (Preferred)

Case Management:

1 year (Preferred)

Clinic:

1 year (Preferred)

Language:

Spanish (Preferred)

Work Location:

In person