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 IPA's 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 patient's eligibility at the time of an accident. MINIMUM QUALIFICATIONS 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. For the RUHS care management program, experience as a Licensed Vocational Nurse or experience equivalent to the County of Riverside Behavioral Health Specialist I class is preferred. Knowledge of: Rules and regulations pertaining to the confidentiality of medical information from federal, state and county agencies; medical terminology and basic laws of healthcare facilities and hospitals; federal, state and county regulations related to healthcare compliance. Ability to: Interpret medical information, diagnosis and apply medical guidelines; communicate effectively orally and in writing; maintain effective working relationships with a wide variety of individuals; work independently, as well as in a team environment; operate a variety of telephone technology systems; understand the capabilities and applications of information processing equipment, considering the requirements of the program; utilize motivational interviewing skills; work efficiently in a fast paced environment; provide excellent customer service. Other Requirements:Skills: Computer literate; ability to type 40 wpm. License: Possession of a valid California Driver's License is required.