Senior Care Coordination Specialist – Hybrid

Blue Shield of California; California; Hybrid; USD 34,000 - 48,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Blue Shield of California is seeking a Clinical Service Coordinator, Advanced to support care coordination for our most vulnerable members. You will assist nurse case managers with escalated cases, research eligibility and benefits, and coordinate with internal and external partners to resolve issues and connect members to needed services.

This hybrid role emphasizes cultural competence, MI practices, and a member-centered approach to help improve health outcomes and access to care while working

Qualifications

• Requires a High School diploma or GED or 1 additional year of relevant experience in lieu of a diploma.
• Requires 5 years of prior relevant experience.
• Desirable certification or training as a patient advocate, health coach, or care navigator.
• Health insurance/managed care experience.
• Experience with community resources and advocacy.
• Strong interpersonal communication and organizational skills.

Responsibilities

• Support nurse case managers and members with escalated cases involving complex care coordination needs.
• Research member eligibility, benefits, claims history, and authorization status to identify barriers.
• Coordinate with internal and external partners to support case resolution.
• Serve as a liaison between nurse case managers, members, providers, and stakeholders.
• Track escalated case activity and communicate next steps to support timely closure.
• Demonstrate cultural competence and member-centered MI practices.

Skills

Interpersonal communication

Organizational skills

Education

High School diploma or GED

Job description

Blue Shield of California is seeking a Clinical Service Coordinator, Advanced to support care coordination for our most vulnerable members. You will assist nurse case managers with escalated cases, research eligibility and benefits, and coordinate with internal and external partners to resolve issues and connect members to needed services.

This hybrid role emphasizes cultural competence, MI practices, and a member-centered approach to help improve health outcomes and access to care while working