Care Coordinator (Hybrid)

Overview
We are seeking a dedicated Medical Management Care Coordinator to join our team remotely, serving California-based patients. This is a TEMP to HIRE role that involves coordinating patient care, supporting medical teams, and ensuring seamless communication within healthcare settings. The ideal candidate will have a strong background in medical office operations and excellent organizational skills to facilitate effective patient management and care delivery.

Schedule: Monday - Friday, 8am-5pm

Pay: $26-$30/hr (Based on experience)

Responsibilities

• Follow established Health Services policies and procedures and use available resources to respond to member and/or provider inquiries and resolve any concerns in an accurate, timely, respectful, professional and culturally competent manner.
• Collaborate with team members on improvement efforts across-departments regarding quality improvement projects, optimization of utilization management, and

member satisfaction

• Develop effective and professional working relationships with internal and external stakeholders and partners. Communicate effectively with members and providers

orally and in writing

• Assist in gathering and processing data for internal required reports and analysis
• Attend and actively participate in daily, weekly, and monthly departmental meetings, in-services, training and coaching sessions
• Follow UM policies and processes to the management of incoming authorization requests received through fax, mail or telephone
• Identify authorization requests for line-of-business, urgency level, type of service, and assess for complete/incomplete record submission
• Perform complete, accurate, and consistent data entry into system software applications in accordance with policies, procedures and instruction from UM

management.

• Answer inbound UM phone queue calls timely to assist members and/or providers regarding inquiries involving authorizations, SCFHP program services, and/or

benefits.

• Process written and verbal notifications of authorization determinations to members and/or providers within regulatory processing timeframes.

Requirements

• High school diploma or GED.
• Minimum two years of experience in a health care setting in positions requiring interaction with members and/or providers.
• MUST be local and able to come in-office on certain days.
• Knowledge of health plan benefits, process and operations related to commercial, Medi-Cal and/or Medicare programs.
• Proficient in adapting to changing situations and efficiently alternating focus between telephone and non-telephone tasks to support department operations as dictated by business needs.

Raul Primary

Job Types: Full-time, Contract, Temporary

Pay: $26.00 - $30.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Vision insurance

Education:

• High school or equivalent (Required)

Experience:

• Medical office: 2 years (Required)
• Utilization management: 1 year (Required)

Work Location: Hybrid remote in San Jose, CA 95119