Clinical Support Specialist II (Hybrid - N. Quincy, MA)

Under the direction of the Manager or their designee, the Clinical Support Specialist II coordinates and performs a full range of advanced level, complex and confidential, administrative duties to assist the clinical functions of the department or program.

Provide administrative support of the Department/Program regular activities, including but not limited all review and tracking activities, internal and external vendor/client meetings.

Distribute necessary Departmental/Program related communications to providers and vendors including sending of communications and tracking responses. Contact vendors and providers to obtain/clarify medical and other related information needed as part of the Program’s process.

Develop and maintain tracking system(s) for all review activity in the Program.

Assist in the develop and maintenance of the Department/Program Standard Operating Procedures (Manual).

Track and assess vendor activity. Including electronic referrals, and preparing pertinent case documentation for review,
Assist in the preparation of audit material.

Participate in the ongoing evaluation of Department/Program activity to identify opportunities for improvement in the quality, efficiency, and effectiveness of the Department/Program towards continual process improvement.

Prepare comprehensive case files for the Board of Hearing.

Administrative support work as needed, and all other duties as assigned.

REQUIRED EDUCATION
Associate degree in related field, or equivalent related experience
REQUIRED WORK EXPERIENCE
5-7 years’ related work experience.
Strong interpersonal and organizational skills.
Excellent problem solver and utility player.
Excellent verbal and written communication skills; and engaging approach that will enrich collaboration.
Ability to work independently and creatively in a rapidly changing environment.
Ability to locate, interpret and implement appropriate MassHealth regulations.
Proficient in Microsoft Office products: Word, Excel, PowerPoint, Outlook.
Ability to learn and embrace new technology to meet the needs of the program.
Possess the organizational, verbal, written and interpersonal skills necessary to interact effectively with all levels of personnel and external stakeholders.
Ability to prioritize, multi-task, shift priorities and execute tasks in a fast-paced environment.
Ability to think critically, analyze, and determine the applicability of data, draw conclusions and make appropriate recommendations.
PREFERRED WORK EXPERIENCE
Bachelor’s degree
Previous health care, medical administrative and/or insurance experience