Coordinator jobs at Alameda Alliance for Health

FLSA Status: Non-Exempt Department: Health Services Reports To: Manager, Community Based Care Management The Community Based Programs (CBP) Coordinator leads and participates in processes and projects to support and improve the operations of the Community Based Programs (CBP) team in alignment with organizational objectives, and in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements. In this role, the Coordinator supports the daily operations of CBP benefits, programs and strategies including serving as primary initial contact for specific referrals and authorization processes. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. * Oversee the processes for referrals and authorizations, including processing the denial and disenrollment for Medi-Cal benefits under the CBP Team in accordance with state and federal regulatory requirements and SCFHP policies and procedures as set forth for each benefit * Perform complete, accurate and consistent authorization processes including review of benefit eligibility and referrals, request and review of medical records and other documentation, as applicable, escalation to clinical staff or management for further determination, and process approval and denial letters or Notice of Action. * Act as the primary initial contact for CBP referrals and communicate with internal departments for additional follow up as necessary and appropriate. * Perform routine duties including accurate and consistent data entry into system software applications, managing and following up on call queues, and working to resolve member and provider inquiries in a timely manner. * Serve as liaison with Grievance and Appeals (G&A) Department for support with CBP related reviews and resolution of member and/or provider issues submitted by G&A * Ensure grievance and appeals cases are accurate and include the necessary elements for processing and resolving, giving special attention to those identified as "Expedite". Create clear and concise documentation in applicable system(s). * Support needs of the CBP team including scheduling, coordinating and documenting meetings, maintaining records, generating mailing lists, setting up documents, onboarding staff and implementing other projects in support of CBP strategies. * Support team staff on reviewing and providing input on member and provider facing materials, including program guides, training slides, and member information flyers * Support management in the process of approving policies, as well as the upload and updating of policy and procedures to PolicyTech platform. * Follow established Health Services policies and procedures and use available resources to respond to member and/or provider inquiries and resolve any concerns in an accurate, timely, respectful, professional and culturally competent manner * Build and maintain expertise and understanding of managed care, SCFHP policies and procedures, department functions and processes and relevant regulatory requirements. * Collaborate with team members on improvement efforts across-departments regarding quality improvement projects, optimization of utilization management, and member satisfaction * Assist in gathering and processing data for internal required reports and analysis. * Attend and actively participate in daily, weekly, and monthly departmental meetings, in-services, training and coaching sessions. * Process written and verbal notifications of authorization determinations to members and/or providers within regulatory processing timeframes. * Perform other duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. * High school diploma or GED. (R) * Associate's degree or equivalent experience, training or coursework. (D) * Minimum two years of experience in customer service, program operations, health services, or in a managed care or community based setting handling escalated or complex issues. (R) * Knowledge of health plan benefits, process and operations. (D) * Experience and comfort working with data entry and system software applications. * Prior experience with public or nonprofit programs, Medi-Cal and/or Medicare programs and working with the underserved populations. (D) * Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills. (D) * Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or event. (R) * Experience with SQL development language and/or Tableau. (D) WORKING CONDITIONS Duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: * Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) * Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) * Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) * Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) * Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) * Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated PHC departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

FLSA Status: Non-Exempt Department: Marketing & Communications Reports To: Supervisor, Community Resource Center Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521 The Community Resource Center (CRC) Coordinator is committed to creating a welcoming experience for all residents visiting the center. The CRC Coordinator supports the day-to-day operation of the CRC, including clerical, administrative and programmatic duties, and is responsible for managing the front desk by answering telephone calls, greeting and registering visitors, actively responding to questions about the CRC and resources, maintaining room reservations, and appropriately addressing issues. The role also supports program success at the CRC by overseeing the CRC Member Rewards Program, helping members and residents sign-up for programs, assisting in program set-up and break down, and ensuring the CRC is well-maintained throughout the day. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below. 1. Prepare for daily opening and closing of the center by properly completing check-list of procedures. 2. Greet and check in all members, community partners, vendors, and other visitors, to build rapport and engagement and create a positive experience at the CRC, following established safety and security guidelines. 3. Assist individuals face-to-face and over the telephone with questions about the CRC, facilitate connection to CRC programs and services, and demonstrate comfort guiding and de-escalating members with concerns, complaints, and challenges accessing care or social services. 4. Effectively communicate with all members, community partners, vendors, and other visitors, to answer general questions by providing information and assistance as appropriate 5. Prepare a variety of correspondence including emails, notices, and minutes for staff, community partners, vendors and visitors. 6. Manage CRC reservation system including scheduling of meetings, trainings, programs, events and services for staff, community partners, vendors and other visitors and maintain and publish calendar information. Register and check-in participants for education and fitness classes, member orientation, enrollment appointments, kids club, etc. 7. Set-up and clean-up all areas of CRC used for group programming and individual consultations. 8. Coordinate rewards program for CRC participants. 9. Develop and maintain inventory of CRC materials, which include but are not limited to brochures, printed material, and health and fitness promotional items. Assist in the ordering of materials. 10. Coordinate onsite meetings, e.g., Consumer Advisory Committee, by confirming RSVPs, booking catering, and preparing, posting and distributing materials in compliance with Brown Act. 11. Report any safety issues or concerns immediately. 12. Answer the phone line in a prompt, professional, and friendly manner; route calls and answer routine questions. 13. Provide general administrative support for CRC, including but not limited to data entry, producing and managing documents and spreadsheets; scanning, copying and indexing; looking up member information; processing returned undeliverable mail; assisting with mailings. Complete required record keeping for tracking results and providing feedback to SCFHP on issues related to member activity/assistance, rewards program, and other CRC activities. 14. Maintain shared workstation in a clean and orderly manner. 15. Draft, maintain and use operating instructions and tools needed to support Department activities and ensure compliance with all regulations. 16. Assist with new hire training by having new hires shadow and observe, in accordance with training guidelines and protocols. 17. Attend and actively participate in daily, weekly, and monthly department meetings, trainings and coaching sessions. 18. Identify issues, trends, and opportunities to improve efficiency and/or quality, or to better assist departments; report relevant information to management. 19. Perform other related duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. 1. High School Diploma or GED. (R) 2. Associate's degree or equivalent experience, training, or coursework. (D) 3. Minimum two years of experience in customer service. (R) 4. Experience working with underserved populations. (R) 5. Proficient in adapting to changing situations and efficiently alternating focus between multiple tasks to support operations as dictated by business needs. (R) 6. Fluent in Spanish, Vietnamese, and/or Chinese. (R) 7. Experience operating general office equipment such as multi-line phones, copiers, printers, scanner, fax, and 10-key. (R) 8. Working knowledge of and the ability to efficiently learn and operate all applicable computer software including computer applications such as Microsoft Word, Excel, Outlook, and Salesforce. (R) 9. Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP members, resident, providers and staff over the telephone, in person or in writing. (R) 10. CPR/First Aid Certification or ability to acquire certification within 3 months. (R) 11. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) 12. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) 13. Ability to maintain confidentiality. (R) 14. Ability to comply with all SCFHP policies and procedures. (R) 15. Ability to perform the job safely with respect to others, to property, and to individual safety. (R) 16. Ability to work weekends and evenings as needed. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, CRC visitors, or providers, in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: 1. Mobility Requirements: regular bending at the waist, stooping, reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) 2. Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 30 pounds; (R) 3. Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) 4. Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard, mailroom equipment); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) 5. Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) 6. Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desk procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers, and tracking completion dates using Excel and other tools. ▪ May process documents within scope of authority within the current platform. ▪ Responsible for tracking and managing all follow-up inquiries from other departments and assigns and/or completes timely. ▪ May maintain Health plan updates within the system when applicable to work assignment and or requested. ▪ May maintain work assignment grid and make assignments as outlined. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. One (1) year of related experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service may be preferred. Special Skills, Licenses and Certifications Excellent written and oral communication with problem solving skills. Proficient data entry, telephone, and computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle workstation with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

FLSA Status: Non-Exempt Department: Health Services Reports To: Director, Behavioral Health The Behavioral Health Services Personal Care Coordinator is responsible for supporting and coordinating internal and external resources for members referred to case management programs for all lines of business in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below. * Work with case managers to assist members navigating the healthcare delivery system and home and community-based service to facilitate access related to medical, psychosocial and behavioral health benefits and services. * Monitor and respond to inbound case management inquiries and referrals and escalate to clinical staff, as appropriate. * Provide outreach to members to facilitate timely completion of Health Risk Assessments (HRA's) by telephone, mail or in person, as needed. * Support the coordination of member care with PCP, Specialists, Behavioral Health and Long Term Services and Supports providers and other stakeholders to assist member to achieve or maintain a level of functional independence which allows them to remain at home or in the community. * Assist with coordinating the involvement of the interdisciplinary care team (ICT) members including the member and/or their family/responsible party to implement the individualized care plan (ICP). Oversee correspondence related to care plans. Document ICT meetings following SCFHP policies and procedures. * Support successful transition of care for members who move between care settings by coordinating services for medical appointments, pharmacy assistance and by facilitating utilization review. Assist to ensure follow up for psychiatric hospitalizations for members to obtain psychiatric/behavioral health care. * Follow UM policies and procedures for new authorization requests. May conduct data entry into the authorization software application system and determination notification to member and/or provider in accordance with regulatory timeframes. * Produce and distribute internal reports that may include QI reports, member admission and discharge reports and external stakeholder reports, as appropriate. * Follow established Health Services policies and procedures and use available resources to respond to member and/or provider inquiries and resolve any concerns in an accurate, timely, respectful, professional and culturally competent manner. * Maintain knowledge of current resources in communities served by our members to support case management goals. * Develop effective and professional working relationships with internal and external stakeholders and partners. Communicate effectively with members and providers orally and in writing. * May support and conduct non-clinical training in accordance with training guidelines and protocols; provide input and develop training and reference materials. May develop Behavioral Health department orientation binder and assist with onboarding of new employees. * Identify issues and trends (data, systems, member, provider, other) as well as general departmental questions/concerns; report relevant information to management; and make recommendations to improve operations. * Collaborate with team members on improvement efforts across-departments regarding quality improvement projects, optimization of utilization management, and member satisfaction. * Attend and actively participate in daily, weekly, and monthly departmental meetings, in-services, training, coaching sessions and external stakeholder meetings. * Understanding of Behavioral Health and 1115 Waiver programs, including Alcohol and Drug Services and assess members for appropriate referrals into these programs. May be required to facilitate Behavioral Health Treatment (BHT) services, including identification of providers, timely access to assessment and treatment. * Perform other duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. * Bachelor's Degree in a health related field or equivalent experience, training or coursework. (R) * Minimum three years of relevant experience in a healthcare or community setting providing care coordination of health and/or social services. (R) * Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R) * Knowledge of Medicare and/or Medi-Cal benefits, community resources and principals of case management. (D) Knowledge of medical terminology. (D) * Knowledge of Santa Clara County Health and Social Services. (D) * Proficient in adapting to changing situations and efficiently alternating focus between telephone and non-telephone tasks to support department operations as dictated by business needs. (R) * Ability to consistently meet accuracy and timeline requirements to maintain regulatory compliance. (R) * Ability to work within an interdisciplinary team structure. (R) * Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific case management programs. (R ) * Ability to use a keyboard with moderate speed and a high level of accuracy. (R) * Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing. (R) * Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) * Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) * Ability to maintain confidentiality. (R) * Ability to comply with all SCFHP policies and procedures. (R) * Ability to perform the job safely and with respect to others, to property and to individual safety. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: * Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) * Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) * Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) * Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) * Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) * Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels

FLSA Status: Non-Exempt Department: Grievance and Appeals Reports To: Supervisor, Grievance and Appeals Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521 The Grievance and Appeals Coordinator is responsible for the beginning-to-end process of receiving, researching and resolving of new and existing member and provider grievance and appeals cases for all lines-of-business including any escalated step of the grievance and appeals process in accordance with state and federal regulatory requirements and SCFHP policies and procedures as set forth for each line of business. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. * Act as a back-up to the Grievance and Appeals Intake Specialist during times of high volume work and/or staffing shortages to ensure appropriate intake of new and existing grievance and appeal cases, assessing the priority of each case and routing to the appropriate staff. * Ensure grievance and appeals cases are accurate and include the necessary elements for processing and resolving, giving special attention to those identified as "Expedite". Create clear and concise documentation in applicable system(s). * Use good judgment and department resources to identify all issues and required actions within a case, appropriately categorize cases and identify required actions in accordance with state and federal regulations. * Produce and manage outbound documents, correspondence and reports in a manner that meets required timeframes. * Ensure adherence with state and federal regulatory timeframes for handling cases including acknowledging cases, resolving cases, monitoring effectuation of resolution, completing resolution letters and communicating with members and providers within required timeframes. * Prepare case files for State Fair Hearings, Independent Review Entities or other escalated types of cases, including documentation of the Statement of Position and case narratives. Represent SCFHP in any hearing proceedings. * Develop effective and professional working relationships with internal and external stakeholders and partners. Communicate effectively with members and providers orally and in writing. * Contact members and providers to seek additional information or clarification regarding grievance and appeals cases and review and resolve issues by requesting medical records, notice of action, or any other pertinent information related to grievances and appeals from medical groups, delegated entities and/or providers. * Perform complete, accurate and consistent data entry into system software applications in accordance with policies, procedures and instruction from the Manager of Grievance and Appeals Operations. * Maintain case files by ensuring that they are documented in accordance with state and federal requirements and organized in a manner that adheres to SCFHP standards and audit requirements. * Participate in retrospective audit and review of cases and complete and correct gaps or errors in data. * Identify operational issues and trends with SCFHP, delegates and other external stakeholders. Communicate these issues internally and externally and assist in formulating appropriate remediation plans. * Assist the Manager of Grievance and Appeals Operations and peers with special projects. Work collaboratively and cross-functionally with other departments to facilitate appropriate resolutions. Work as a team to complete departmental tasks to meet deadlines and accomplish department objectives. * Attend and actively participate in Grievance and Appeals Committee meetings, operational meetings and department meetings, trainings and coaching sessions. * Perform other related duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. * High School diploma or GED. (R) * Associate's degree or equivalent experience, training or coursework. (D) * Minimum two years of experience in customer service, provider service, health service, or pharmacy in a managed care or health care environment handling escalated or complex issues. (R) * Knowledge of health plan benefits, processes and operations. (R) * Prior experience with commercial, Medi-Cal and/or Medicare programs and working with the underserved populations. (R) * Work weekends and company holidays as needed based on business regulatory requirements. (R) * Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills. (D) * Detail-oriented with the ability to conduct research and identify steps required to resolve issues and follow through to effectuation.(R) * Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the Grievance and Appeals Department operations as dictated by business needs (R) * Ability to consistently meet grievance and appeals accuracy and timeline requirements by achieving regulatory standards. (R) * Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word and Excel. (R) * Ability to use keyboard with moderate speed and a high level of accuracy. (R) * Excellent communications skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, Members, Providers and outside entities over the telephone, in person or in writing. The ability to remain calm and de-escalate tense situations. (R) * Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) * Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) * Ability to maintain confidentiality. (R) * Ability to comply with all SCFHP policies and procedures. (R) * Ability to perform the job safely with respect to others, to property and to individual safety. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: * Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) * Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) * Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) * Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment; (R) * Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) * Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office and call center conditions. May be exposed to moderate noise levels.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desk procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers, and tracking completion dates using Excel and other tools. ▪ May process documents within scope of authority within the current platform. ▪ Responsible for tracking and managing all follow-up inquiries from other departments and assigns and/or completes timely. ▪ May maintain Health plan updates within the system when applicable to work assignment and or requested. ▪ May maintain work assignment grid and make assignments as outlined. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. One (1) year of related experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service may be preferred. Special Skills, Licenses and Certifications Excellent written and oral communication with problem solving skills. Proficient data entry, telephone, and computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle workstation with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated Partnership departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated PHC departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated PHC departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated PHC departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated PHC departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated Partnership departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To plan, organize, manage, and implement projects. Responsibilities Develops and maintains detailed project plans and budget summaries. Coordinates and facilitates both internal and external meetings. Supports projects with a range of low to medium complexity, scope, and schedule. Supports the successful implementation of projects within timelines for associated department assignments and tasks. Provides technical and administrative support for the development of business cases and system reports for projects and/or programs. Develops and publishes agendas, meeting minutes, and necessary documentation. Works with department to develop tactical department and program initiatives. Works with relevant units to develop effective and high quality projects to meet the needs of associated PHC departments. Identifies and manages project deliverables, dependencies, and critical path milestones. Attends project meetings, follows up on assigned tasks, and communicates the status of projects to the supervisor. Develops and publishes communications to project stakeholders. Manages, tracks, and processes project paperwork. Maintains department files (hard and soft copies) per instruction. Other duties as assigned. Qualifications Education and Experience High School diploma or equivalent. Minimum of one (1) year project coordination experience. Special Skills, Licenses and Certifications Strong organization skills with ability to prioritize assignments, manage time effectively, and coordinate project activities between multiple groups. Effective communication skills, both verbal and written, to interpret and articulate project requirements to involved stakeholders. Ability to interpret project requirements and project budget. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Maintains confidentiality and integrity at all times. Work Environment And Physical Demands More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $34.79 - $43.48 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desk procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers, and tracking completion dates using Excel and other tools. ▪ May process documents within scope of authority within the current platform. ▪ Responsible for tracking and managing all follow-up inquiries from other departments and assigns and/or completes timely. ▪ May maintain Health plan updates within the system when applicable to work assignment and or requested. ▪ May maintain work assignment grid and make assignments as outlined. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. One (1) year of related experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service may be preferred. Special Skills, Licenses and Certifications Excellent written and oral communication with problem solving skills. Proficient data entry, telephone, and computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle workstation with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

The Coordinator II will coordinate assigned departmental projects and provide complex administrative support to department leaders. Develops, implements and monitors processes, tools, and systems for collecting, tracking and managing information required for monitoring performance and deadlines. Develops and produces reports. In addition to the Coordinator I duties, the Coordinator II may handle escalated calls, escalated Helpdesk inquiries, and may follow up with providers regarding missing documentation. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desktop procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers and tracking completion dates using Excel and other tools. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ May process documents within scope of authority but require additional knowledge and skillset than that of a Coordinator I. ▪ May handle escalated calls and emails from providers and or internal partners. ▪ Assists with creating training plans and onboarding of new staff to include chair-side training. ▪ May provide new hire orientation and training. ▪ If applicable, reconciles capped provider discharges within our platform. ▪ If applicable, contacts providers directly to reconcile records to manage volume for nurse coordinator work assignment accuracy and monitoring. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Makes presentations to internal PHC audiences of all levels. ▪ Provides guidance and education on departmental contacts, resources and information. ▪ Provides training and support to staff in the use of software, department programs, policies, and procedures. ▪ Assists with requests from other departments by investigating facts, providing information, and/or escalating the issue to the appropriate person as needed. ▪ Participates in the design of process improvements and supports the department with development of procedures, tracking and reporting tools. ▪ Participates in special projects, assignments and/or other tasks as needed. ▪ Coordinates and monitors inventory control processes to ensure production standards are met. ▪ Monitors reporting schedules and regulatory deadlines to ensure deadlines are met. Secondary Duties and Responsibilities ▪ May support and cross trains to fill in for Authorization Specialist assignment. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. At least two (2) to four (4) years of related experience required in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service Special Skills, Licenses and Certifications Excellent oral communication with problem solving skills. General knowledge of managed care. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Knowledge of computers and related applications and familiarity with spreadsheet applications. Minimum typing speed of 40 wpm. Knowledge of alpha-numeric filing systems. Proficient in use of Microsoft Suite. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent oral and written communication skills and customer service orientation. Must be able to work in a fast-paced environment and maintain courtesy and composure. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians and health care providers. Ability to function effectively with frequent interruptions. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle work station with a shared common area. Ability to use a computer keyboard. Must be able to work in a fast-paced environment and maintain courtesy and composure. Ability to function effectively with frequent interruptions. Must be able to lift, move or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $28.94 - $34.00 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desk procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers, and tracking completion dates using Excel and other tools. ▪ May process documents within scope of authority within the current platform. ▪ Responsible for tracking and managing all follow-up inquiries from other departments and assigns and/or completes timely. ▪ May maintain Health plan updates within the system when applicable to work assignment and or requested. ▪ May maintain work assignment grid and make assignments as outlined. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. One (1) year of related experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service may be preferred. Special Skills, Licenses and Certifications Excellent written and oral communication with problem solving skills. Proficient data entry, telephone, and computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle workstation with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desk procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers, and tracking completion dates using Excel and other tools. ▪ May process documents within scope of authority within the current platform. ▪ Responsible for tracking and managing all follow-up inquiries from other departments and assigns and/or completes timely. ▪ May maintain Health plan updates within the system when applicable to work assignment and or requested. ▪ May maintain work assignment grid and make assignments as outlined. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. One (1) year of related experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service may be preferred. Special Skills, Licenses and Certifications Excellent written and oral communication with problem solving skills. Proficient data entry, telephone, and computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle workstation with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations. Responsibilities ▪ Provides administrative support to management and general office and clerical duties as needed to support the department. ▪ Documents desk procedures and updates annually to ensure content is current. ▪ Enters data into various software systems. Maintains and updates all databases in use accurately. Uploads department documents and files to SharePoint ensuring content is organized and up to date. ▪ Processes inventory by receiving and scanning documents, assigning numbers, and tracking completion dates using Excel and other tools. ▪ May process documents within scope of authority within the current platform. ▪ Responsible for tracking and managing all follow-up inquiries from other departments and assigns and/or completes timely. ▪ May maintain Health plan updates within the system when applicable to work assignment and or requested. ▪ May maintain work assignment grid and make assignments as outlined. ▪ Produces and maintains correspondence, forms, reports, and other needed documentation. ▪ Verifies member eligibility both electronically and using online systems. ▪ Intakes information over telephone from providers for referrals and authorizations. ▪ Performs general office and clerical duties as needed to support the department; opens, sorts, date stamps, and distributes mail; answers telephones and determines urgency and priority of requests, questions, and issues; routes calls to appropriate staff in a courteous and professional manner; copies, faxes, files, and generates routine letters to providers and members. ▪ Coordinates meetings, including but not limited to, creating agendas, taking minutes, and setting up conference rooms. ▪ Other duties as assigned. Qualifications Education and Experience High School Diploma or equivalent. One (1) year of related experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone-based customer service may be preferred. Special Skills, Licenses and Certifications Excellent written and oral communication with problem solving skills. Proficient data entry, telephone, and computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred. Performance Based Competencies Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. Work Environment And Physical Demands Daily use of telephone and computer for most of the day. Standard cubicle workstation with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.