Full Job Description
We are seeking a dedicated Case Management Coordinator II to join our team for a temporary assignment in Montebello, CA. In this role, you will utilize your knowledge of prior authorization and case management regulations across Medi-Cal, Medicare, Commercial, CCS, and other government programs.
Job Details:
- Temp assignment
- Location: Montebello, CA
- Schedule: Monday – Friday 8am – 5pm, Hybrid (onsite on Tuesdays)
- Pay Range: $23 – $26/hr
Qualifications:
- High school diploma required
- 2+ years of experience in a healthcare setting
- Knowledge of managed health care environments (IPA, HMO, Health Plan)
- Bilingual English/Spanish preferred
- Medical Billing Certification and Medical Assistant experience strongly preferred
Responsibilities
1. Input data into the case management system to ensure timely care coordination and outreach.
2. Verifies member benefits and eligibility upon receipt of care coordination and/or case management.
3. Utilizes DOFR and/or delegation agreements to drive decision-making.
4. Coordinates and assists with patient appointments, transportation, and/or community resources.
5. Has primary responsibility for gathering relevant information for the identified member population during
assessment, care planning, interdisciplinary care team meeting, and transitions of care.
6. Completes applicable patient assessments.
7. Completes low risk problem solving and coordination for patients in collaboration with case manager.
8. Outreach to patients to verify that needs are being met and services are being delivered.
9. Intervenes at the client level to coordinate the delivery of direct services to clients and their families.
10. Coordinates with Primary Care and Specialist providers.
11. Collaborates and facilitates interdisciplinary team communications.
12. Perform additional duties as assigned.
13. Process model of care required elements within the dept. targets.
14. Meets minimum caseload requirements.
15. Achieves minimum audit score for core responsibilities.
If you’re passionate about making an impact in healthcare, apply today!
Pay: $23.00 – $26.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Vision insurance
Education:
- High school or equivalent (Required)
Experience:
- Prior authorization : 1 year (Preferred)
- Case management: 2 years (Preferred)
- Insurance verification: 1 year (Preferred)
- Managed care: 1 year (Preferred)
Ability to Commute:
- Montebello, CA 90640 (Required)
Work Location: Hybrid remote in Montebello, CA 90640
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