Clinical Services Coordinator, Specialist

Your Role

The Federal Employee Program - Clinical Support Coordinator Team is responsible for phone and fax intake, and supports the Prior Authorization, Utilization Management, and Care Management teams. The Quality Lead Clinical Support Coordinator will report to the Manager FEP Non-Clinical Operations. In this role you will provide direct operations and training support to the Clinical Support Coordinator Team, perform coaching audits, outreach and engagement calls, and provide help on phones, faxes, email, and mail as needed.

Your Work

In this role, you will:

• Support CSC CM staff to maintain quality and production targets
• Be a resource for training and ongoing support of the FEP Care Management CSC team
• Handle member and provider escalated calls
• Build cases and process information from calls, faxes, emails, and mailed correspondence and enter Eligibility File into the master system when needed
• Precept new hires & coordinate precepting assignments
• Assist with process and system related issues, develop and implement solutions
• Create, organize, review, and share pertinent resource documents with team members
• Work with other Leads, Seniors, Supervisor, Manager, and Business Analyst to drive team success
• Complete quality audits monthly and provide coaching feedback to team members as needed
• Monitor and shift resource needs to cover assigned team tasks as necessary
• Provide backup to FEP Non-Clinical team when needed

Your Knowledge and Experience

• Requires at least 7 years of prior relevant experience, FEP LOB experience preferred
• Must be able to support team members and department goals
• Must be strong and effective communicator, with the ability to multi-task
• Must have experience as a Senior/Advanced Clinical Support Coordinator or equivalent experience
• Must have strong attendance record
• Must be able to sit for extended periods of time and read information on one computer screen and apply that information on a second computer screen to complete documentation
• Must be able to support team members and department goals