Clinical Services Coordinator, Intermediate
Company: Blue Shield of California
Location: North Highlands
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 (Appointment Assistance) 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: Serve as a primary point of contact for
members by providing support via inbound and outbound phone
interactions Conduct outreach to healthcare providers and programs
to obtain information on services and appointment availability,
coordinate appointments, and ensure continuity of care. Work in a
production-based environment with defined production and quality
metrics. 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
network availability. Data entry including authorization forms,
high risk member information, verbal HIPPA authorizations
information for case creation. 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, San Rafael , Clinical Services Coordinator, Intermediate, Healthcare , North Highlands, California
