Patient Services Coordinator-Housing Regional Administration

For questions regarding this position please contact the Recruiter listed in the Supplemental Information section.

This role processes referrals from internal departments Medi-Cal managed care plans (IEHP Molina Kaiser) hospitals detention facilities and community partners. Responsibilities include reviewing referral packets applying DHCS and MCP guidelines to determine non-clinical eligibility verifying Medi-Cal enrollment and coverage and submitting authorization requests within required timelines.

The Patient Service Coordinators conduct monthly member reviews track service utilization and the 182-day room-and-board cap and maintains accurate timely documentation in the electronic health record (EHR). The position also tracks reauthorizations coordinates with care teams and providers to prevent service gaps and ensures compliance with all documentation and program requirements.

Additional duties include processing denials maintaining audit-ready records supporting workflow improvements and serving as a central point of coordination among internal teams managed care plans vendors and community providers.

A valid California drivers license is required. Bilingual Spanish is preferred but not required.

The most competitive candidates will demonstrate experience with CalAIM Community Supports Enhanced Care Management (ECM) and/or Medi-Cal managed care addition candidates should possess knowledge of homeless services systems including the Coordinated Entry System (CES) as well as housing programs such as Short-Term Post-Hospitalization (STPH) Transitional Rent (TR) Recuperative Care Housing Transition & Navigation (HTNS) and Housing Tenancy & Sustaining Services (HTSS). Experience with Epic systems is highly desirable. Candidates with experience serving individuals experiencing homelessness behavioral health conditions and/or substance use disorders are strongly preferred.

Work schedule: 9/80 schedule: Monday through Thursday 8:00 a.m. to 5:30 p.m.; Friday 8:00 a.m. to 4:30 p.m. with every other Friday off.

Meet the Team!

Riverside University Health System Behavioral Health is a leading provider of mental health and substance use services in Riverside County. With a dedicated team of professionals including psychiatrists clinicians peer specialists and paraprofessionals RUHS-BH serves over 45000 individuals annually.

We are committed to delivering culturally competent evidence-based care across all ages. Our programs including Mental Health Services Substance Use Services and the Public Guardians Office address the diverse needs of our community.

At RUHS Behavioral Health youll join a compassionate innovative team where your skills make a real difference. We offer opportunities for growth collaboration and meaningful impact.

If youre passionate about advancing your career while improving mental health in Riverside County RUHS Behavioral Health is the place for you!

For more information please visit OF ESSENTIAL DUTIES

Assist physicians and other healthcare providers by providing care coordination to ensure patients receive optimal care; interact with Primary Care Providers Specialty Providers and other healthcare staff to coordinate care for patients.
Liaison between healthcare staff and patients regarding maintenance of care and treatment; work closely with Providers to ensure continuity of care and treatment; facilitate communication among patients physicians nurses and other healthcare staff regarding their care including making appointments treatment authorizations and resource needs.
May assist with patient referrals to appropriate community resources; may provide patient education.
Daily management of referrals which includes input of data into manage care system verify member eligibility provider participation and tracking of pending referrals.
Authorize Treatment Authorization Requests (TAR) for the County of Riverside Medically Indigent Services Program (MISP); coordinate Durable Medical Equipment (DME) for all Managed Care Health Plans public and private coordinating quotes and equipment availability.
Assist with transfer of patients to and from RUHS Medical Center and Care Clinics and other outlying hospitals for specialized care; verify patient eligibility with associated health plans.
Coordinate with contracted IPAs and return copies of all appropriate clinic surgery and emergency room progress notes; process and authorize all requests for pharmacy that are not covered in the Drug Formulary.
Request and review all emergency room notes for managed care patients that are seen through the Emergency Department; ensure return of all notes (i.e. outpatient surgical and emergency) to appropriate PCP or IPA.
Coordinate patient transfers to other facilities for higher-level of care; coordinate with Medical Social Workers to facilitate care for patients; assist patients in qualifying for Medi-Cal or other programs.
Process Third Party claims by determining and supplying information to and from attorney respective of patients eligibility at the time of an accident.

Education: Graduation from high school or possession of a Certificate of Proficiency issued by the California State Board of Education or attainment of a satisfactory score on a G.E.D. test.

Experience: Three years of increasingly responsible broad and varied clerical experience at least one year of which included working in a managed care healthcare or behavioral health setting.

Who May Apply:

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APPLICATION INFORMATION

Veterans Preference
The County has a Veterans Preference Policy applicable to new hires. To qualify attach the required documents to your job application. Documents include a copy of your (or your spouses) Member-4 Form DD-214 indicating dates of service. For spousal preference and as applicable the following documents: a copy of your marriage certificate spouses death certificate a letter of spouses disability and/or letter of service-related death (if available) from the U.S. Veterans Administration. For privacy reasons it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans preference. For complete details and documentation requirements please review the Veterans Preference Policy C-3 here: Accommodations
The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation please visit the Disability Access Office web page located at: of Education
If using education to qualify or when requested by the recruiter upload a copy of any license(s) official/unofficial transcript(s) degrees and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted.

If your education was completed outside of the United States you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services (NACES) or Association of International Credential Evaluators Inc. (AICE).

Work Authorization Requirement
Applicants must be legally authorized to work in the United States at the time of application. The County of Riverside does not participate in visa sponsorship programs including H1-B visas and will not provide sponsorship for any employment-based visas.

Equal Opportunity Employer
The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race color religion sex national origin age disability sexual orientation gender gender identity gender expression marital status ancestry medical condition (cancer and genetic characteristics) genetic information or denial of medical and family care leave or any other non-job-related factors.

Pre-Employment
All employment offers are contingent upon successful completion of pre-employment requirements including a criminal background investigation which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A pre-employment physical examination and background check may be required.

Probationary Period
As an Approved Local Merit System all County of Riverside employees except those serving At Will are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding County Resolution or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head.

General Information
Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies.

Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered.

Please read and follow any special application instructions on this posting. Click the Apply link located on this page to submit your application. For additional instructions on the application process examinations Veterans preference pre-employment accommodation or other employment questions please refer to our web site .

If you are experiencing technical problems you may contact the applicant support desk Monday through Friday 6 am to 5 pm Pacific Time at or toll-free 1-.