Clinical Operations Assistant I

Gold Coast Health Plan will not sponsor applicants for work visas

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in.

POSITION SUMMARY

The Gold Coast Health Plan (GCHP) Clinical Operations Assistant I (COA I), supports non-clinical utilization/care management activities. The COA I coordinates with registered nurses to meet daily operational objectives and program goals. This position communicates with internal and external customers to support health services efforts. The COA I, is vital in representing the GCHP values to our customers through courteous and professional communication.

ESSENTIAL FUNCTIONS

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help

enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statements

* Assists RN with coordination of care services, such as interfacing with out of network providers to identify potential care providers for specialty care needs.

* Telephonic contact with providers to assist in screening for specific care needs (i.e. referrals to CCS, Care Management).

* Manage incoming and outgoing faxes, ensuring timely processing and accurate documentation.

* Case creation and distribution to nursing team.

* Develop positive working relationships with external and internal customers.

* Maintains and updates tracking databases as directed.

* Ability to work in a fast-paced environment with changing priorities.

* Documents nonclinical interventions as appropriate.

* Other duties as assigned.

POSITION QUALIFICATIONS

Competency Statements

* Active Listening - Ability to actively attend to, convey, and understand the comments and questions of others.

* Applied Learning - Ability to participate in needed learning activities in a way that makes the most of the learning experience.

* Communication, Oral - Ability to communicate effectively with others using the spoken word.

* Customer Oriented - Ability to take care of the customers' needs while following company procedures.

* Detail Oriented - Ability to pay attention to the minute details of a project or task.

* Initiative - Ability to make decisions or take actions to solve a problem or reach a goal.

* Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.

SKILLS & ABILITIES

Education:

High School Graduate or General Education Degree (GED): Required

Ability to speak, read, and write Spanish is necessary for certain positions.: Required

Experience:

Previous experience working with medical terminology. Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

Computer Skills:

Advanced computer skills included in the MS Office products and data base programs (Word, Excel and Microsoft Access a plus).

Other Requirements:

* Ability to multi-task, both with and without supervision; attention to detail and a tolerance for handling large amounts of data; ability to quickly analyze and interpret data with decisiveness.

* Critical thinking skills as demonstrated by the ability to problem-solve complex, multifaceted situations.

* Strong organizational and prioritization skills.

* Ability to type at least 45 words per minute.

* Strong written and verbal communication skills

* Knowledge of medical terminology

* Patient advocacy focus.