Community Programs Coordinator: Drive Care Access & Approvals

Santa Clara Family Health Plan; San Jose (CA); On-site; USD 62,000 - 89,000; Full time

Job summary

Santa Clara Family Health Plan is seeking a CBP Coordinator to lead and support Community Based Programs operations. You will manage referrals and authorizations, review eligibility, and prepare correspondence while coordinating with clinical staff and other departments.

The role emphasizes data entry, timely member/provider communications, and collaboration on quality improvement and policy updates within a health services team.

Qualifications

• High school diploma or GED required; associate degree preferred.
• 2+ years in customer service, program operations, or health services.
• Experience with health plan benefits and managed care is preferred.
• Bi-lingual skills in Spanish, Vietnamese, Chinese, or Tagalog are a plus.
• Experience with data entry and health information systems is desirable.

Responsibilities

• Oversee referrals and authorizations per regulatory requirements and policies.
• Process benefit eligibility reviews and prepare approval/denial communications.
• Serve as primary contact for CBP referrals and coordinate with internal teams.
• Enter data accurately, manage call queues, and address member/provider inquiries.
• Support document preparation for policy updates and program materials.

Education

High school diploma or GED

Associate’s degree

Data entry

Spanish, Vietnamese, Chinese, or Tagalog language skills

Customer service experience

SQL development language and/or Tableau

Tools

Tableau

SQL

Job description

Santa Clara Family Health Plan is seeking a CBP Coordinator to lead and support Community Based Programs operations. You will manage referrals and authorizations, review eligibility, and prepare correspondence while coordinating with clinical staff and other departments.

The role emphasizes data entry, timely member/provider communications, and collaboration on quality improvement and policy updates within a health services team.