About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose: 

The Clinical Coordinator serves to optimize clinical workflows, EHR systems, reporting processes, and care coordination to improve patient outcomes, support efficient care delivery, and ensure timely completion of assessments and care plans.

The Clinical Coordinator acts as a key liaison between members, nurses, navigators, providers, and internal teams, supporting efficient workflows while delivering a positive, member-centered experience consistent with Fallon Health’s Model of Care and interdisciplinary team approach.

Primary Job Responsibilities: 

Member & Customer Service Support

• Serves as a primary point of contact for members, caregivers, and providers regarding nurse appointments, assessments, and care coordination activities, ensuring courteous, professional, and culturally sensitive interactions.
• Explains scheduling processes, next steps, and expectations clearly to members and caregivers, reinforcing trust and engagement.
• Demonstrates strong service recovery skills by addressing scheduling issues, barriers to access, and member concerns in a timely manner.

(Customer-service–oriented behaviors are consistent with Fallon Health operational roles and embedded across care management support functions.)

Scheduling & Care Coordination

• Coordinates and schedules nurse case management activities, including initial assessments, annual reassessments, transitions of care follow-ups, and interdisciplinary care team meetings.
• Supports nurse case managers and navigators by managing appointment logistics, calendars, and coordination across disciplines to ensure efficient use of clinical time.
• Tracks appointment completion, cancellations, and reschedules, escalating barriers or delays to leadership as appropriate.

Clinical Workflow & Documentation Support

• Supports accurate and timely documentation by ensuring required scheduling and encounter-related data is entered into designated systems (e.g., TruCare or other Fallon Health platforms).
• Uses technology to document scheduling actions, track follow-up needs and communicate updates to clinical staff and care teams.
• Maintains awareness of regulatory and program-specific scheduling requirements (e.g., assessment timeframes, reassessment cycles).

Interdisciplinary Team Support

• Works closely with Care Teams as part of an interdisciplinary care team model, supporting coordinated workflows and communication.
• Participates in team meetings, huddles, or care coordination discussions as needed to support operational flow and member access.

• Associate’s degree required, bachelor’s degree in healthcare, human services, or related field preferred.
• Equivalent healthcare or care coordination experience in lieu of degree
• Minimum of 2 years of experience in healthcare scheduling, care coordination, customer service, or care management support.
• Experience working with nurses, care managers, or interdisciplinary healthcare teams is strongly preferred.

Experience

• Minimum of 2 years of experience in healthcare scheduling, care coordination, customer service, or care management support.
• Experience working with nurses, care managers, or interdisciplinary healthcare teams is strongly preferred.

Preferred Qualifications

• Experience in managed care, health plans, or complex care management environments.
• Familiarity with care management or utilization management systems (e.g., TruCare or similar platforms).
• Knowledge of Medicare, Medicaid, or long-term services and supports (LTSS) populations.

Pay Range Disclosure:

In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $25.28 - $28.62 per hour, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.