Utilization & Care Coordinator (Hybrid in El Segundo)

24 Hour Home Care - Caregiver Division; El Segundo (CA); Híbrido; USD 31.000 - 34.000; Tempo integral

Resumo da vaga

24 Hour Home Care - Caregiver Division in El Segundo, CA is hiring a Community Supports Coordinator, Utilization Management. You will monitor utilization of authorized services, coordinate reauthorizations, and engage members and caregivers to ensure continuity of care in a hybrid role with monthly in-office presence.

Minimum 1–3 years in customer service, Salesforce experience, and strong communication skills are essential. Bilingual Spanish is a plus.

Qualificações

• High school diploma or GED required; bachelor’s degree preferred.
• 1–3 years of customer service or related experience.
• Experience managing customer inquiries, service requests, or cases in a high-volume environment.
• Experience using Salesforce or similar CRM or case management systems.
• Bilingual Spanish preferred.

Responsabilidades

• Monitor member utilization of authorized services, identify underutilization trends, and conduct proactive outreach to help members maximize available service hours.
• Coordinate reauthorization activities, including tracking authorization expiration dates, gathering required documentation, and following up with health plans and Case Managers.
• Serve as a primary point of contact for members and caregivers, responding to inquiries, addressing service concerns, and supporting continuity of care.
• Collaborate with internal teams, health plans, and external partners to resolve authorization discrepancies, service barriers, and other utilization-related issues.
• Maintain accurate member records, utilization activity, and case documentation in Salesforce while ensuring compliance with established policies and HIPAA requirements.

Conhecimentos

Utilization monitoring

Reauthorization coordination

Customer service

Member engagement

Written communication

Verbal communication

Problem solving

Attention to detail

Organization

Time management

Cross-functional collaboration

Formação

Bachelor’s degree preferred

Ferramentas

Salesforce

Descrição da vaga

24 Hour Home Care - Caregiver Division in El Segundo, CA is hiring a Community Supports Coordinator, Utilization Management. You will monitor utilization of authorized services, coordinate reauthorizations, and engage members and caregivers to ensure continuity of care in a hybrid role with monthly in-office presence.

Minimum 1–3 years in customer service, Salesforce experience, and strong communication skills are essential. Bilingual Spanish is a plus.