Care Coordination Specialist
Job Description
Location:
Tallahassee, FL
Department:
Care Coordination
F/T or P/T status:
Full-time
Work schedule/hours:
Monday - Friday, 8:00 a.m. - 5:00 p.m.
About the role:
We are seeking a Care Coordination Specialist to support critical functions within our Care Coordination Department, including utilization management, case management, and the grievance and appeals process. This role plays an important part in ensuring that clinical and administrative decisions are accurate, well‑documented, and completed in accordance with regulatory and organizational standards.
The Care Coordination Specialist assists with the collection and analysis of clinical and non‑clinical information, maintains detailed documentation related to complex determinations, and collaborates with internal teams, providers, and members to facilitate timely resolutions. This position also supports quality improvement initiatives and organizational readiness for accreditation reviews and regulatory audits.
We're looking for someone who has:
- Associate's degree from an accredited two‑year college or technical school, or an equivalent combination of education and experience
- Six months to one year of related experience; healthcare or clinical environment experience preferred
- Strong analytical and problem‑solving skills, with the ability to research and interpret clinical, benefit, and regulatory information
- Excellent written and verbal communication skills, including the ability to prepare reports and present information to leadership or cross‑functional teams
- Proficiency with Microsoft Office applications and electronic documentation systems
Highly preferred candidates also have:
- Two or more years of relevant experience in a clinical or healthcare setting
- Experience supporting utilization management, case management, grievances, appeals, or quality‑related processes
- Familiarity with healthcare regulations, accreditation standards, and audit readiness activities
About Capital Health Plan (CHP):
CHP is a locally based, not‑for‑profit health maintenance organization serving the Tallahassee region for more than four decades. Founded by community leaders with a mission to deliver high‑quality, affordable, and patient‑centered health care, CHP has grown into a nationally recognized healthcare organization while remaining deeply rooted in the communities it serves.
CHP is proud to be an Equal Opportunity Employer and is committed to maintaining a workplace that values professionalism, integrity, and respect. We provide equal employment opportunities to all employees and applicants and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected status.