Managed Care Outreach & Authorization Specialist

Pacific Clinics; San Jose (CA); On-site; USD 3,923,000 - 4,824,000; Full time

Benefits offered by this job

Benefits eligibility day one

401K employer match up to 4%

Competitive time off

License differential 8% for LMFT/LCSW/

Bilingual differential up to 7.5%

Job summary

Pacific Clinics seeks an organized administrative professional to support managed-care programs, referrals, and billing processes. The role engages with clinical and finance teams to maintain program integrity and compliance.

The candidate will handle documentation, staff assignments, and enrollment communications, ensuring timely processing and accurate data in a fast-paced healthcare setting.

Qualifications

• High School Diploma or GED and two years of related experience, or equivalent combination of education and experience.
• Six months of experience in an administrative position in the Mental Health field.
• One year experience in an administrative position in the Mental Health field where data management and visualization tasks were involved.
• Must pass DOJ, FBI, and CAIC background clearance.

Responsibilities

• Provides administrative support to ensure programs meet customer, referral, payor, and staff needs.
• Assists with internal process improvements to ensure accountability for fiscal and administrative operations.
• Review TEL List and assign staff to clients in HHE and HHP.
• Deactivate excluded referrals and communicate deactivations to enrollees per process.
• Monitor Medi-Cal status and coordinate with clinical staff and Billing.

Skills

Excel proficiency

Administrative support

Data management

Education

High School Diploma or GED

Job description

Pacific Clinics seeks an organized administrative professional to support managed-care programs, referrals, and billing processes. The role engages with clinical and finance teams to maintain program integrity and compliance.

The candidate will handle documentation, staff assignments, and enrollment communications, ensuring timely processing and accurate data in a fast-paced healthcare setting.