Location: Los Angeles, CA

Schedule: Full Time / Hours between 8am & 5pm.

Pay: $23 - $26 - Depending on Experience

Job Type: Temporary Assignment

Job Summary: This position has primary responsibility for gathering relevant information for the identified member population during assessment, care planning, interdisciplinary care team meeting, and transitions of care. This position performs troubleshooting when problems situations arise and takes independent action to resolve complex issues.

Key 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 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.Facilitates documentation and communication with CCS authorizations, third-party payers and clinical staff to ensure authorization of services. 

12.Responsible for ensuring all community resources are explored and/or exhausted prior to purchase of service utilization. 

13.Serves as an associate and resource to patients, providers, staff, and external customers regarding policies, benefits, and care coordination. 

14.Demonstrates excellent communications skills and interpersonal relationships. 15.Collaborates and facilitates interdisciplinary team communications. 

16.Perform additional duties as assigned. 

17.Process model of care required elements within the dept. targets. 

18.Meets minimum caseload requirements. 

19.Achieves minimum audit score for core responsibilities.

Work Environment:

 1. Work is in an office environment, climate controlled through central air conditioning.

 2. May have some exposure to outside environments while traveling.

Required Skills and Abilities:

 1. Knowledge of medical terminology and coding (e.g., ICD-10, CPT, HCPCS). 

2. Knowledge of the health care industry, preferably managed care. 

3. Knowledge of computer skills in word processing, authorization systems and spreadsheets. 

4. Ability to type a min. of 30 words per minute. 

5. Knowledge of HIPAA Guidelines including the PHI privacy requirements. 

6. Exceptional organizational skills. 

7. Knowledge of CCS Benefit in relation to Managed Care. 

8. Bilingual English/Spanish strongly preferred. 

9. Demonstrates excellent communications skills and interpersonal relationships.

Physical Requirements: 

1. Ability to sit, stand, stoop, reach, lift (up to 10 pounds), bend, etc. hand and wrist dexterity to utilize computer/ and telephones. 

2. May require travel to sites/programs and special functions.