Community Services Program Coordinator ACO SCO

Fallon Health•Worcester, MA

About The Position

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 Community Services Program Coordinator is an individual‑contributor, operational role responsible for the day‑to‑day coordination and execution of assigned Fallon Health’s community‑based programs, including ACO Community Partner programs (Behavioral Health and LTSS), Aging Services Access Points (ASAPs), Geriatric Service and Support Coordinators (GSSCs), and Health‑Related Social Needs (HRSN) services. This role focuses on accurate processing, tracking, communication, and workflow adherence, serving as a primary operational point of contact for internal teams and external partners. The Coordinator executes established processes, supports program performance through timely data and reporting, and escalates clinical, compliance, or complex issues to Program Management or Care Management leadership as appropriate.

Requirements

Associate degree required
2–4 years of experience in healthcare, behavioral health, LTSS, or community‑based services
Excellent communication and organizational skills;
Ability to multi-task and manage competing priorities
Critical thinking skills for independent problem solving;
Experience coordinating and collaborating with multiple internal/external stakeholders coordinate and collaborate with CP Partners;
Capable of merging, synthesizing and validating data from multiple sources;
Ability to conduct accurate and timely data entry.
Satisfactory Criminal Offender Record Information (CORI) results.
Reliable transportation

Nice To Haves

Bachelor’s degree preferred (Social Work, Human Services, Health Services, or related
Experience with Medicaid ACOs, Community Partners, ASAPs, GSSCs, or LTSS vendors preferred

Responsibilities

Program Coordination & Execution
Coordinate and track referrals for Behavioral Health CP, LTSS CP, and HRSN programs, ensuring accurate member assignment and enrollment.
Maintain accurate program rosters, referral logs, and tracking tools to support operational performance and reporting.
Support monthly workflows related to LTSS, CP, ASAP, and GSSC coordination.
Partner & Internal Communication
Serve as an operational point of contact for assigned Community Partners, LTSS vendors, ASAPs, GSSCs, HRSN agencies, and internal care teams.
Respond to routine partner, vendor, and service‑related inquiries, including PCA and non‑medical transportation questions, in accordance with established guidelines.
Participate in internal and external meetings and support documentation, follow‑up, and action tracking.
LTSS & Utilization Support
Support LTSS utilization management and authorization workflows in collaboration with Care Management and UM staff.
Identify workflow issues, member access barriers, or recurring partner challenges and escalate to Program Management.
Data, Reporting & Compliance Support
Prepare and maintain operational reports and data extracts for internal teams (SCO or ACO), Community Partners, ASAPs and EOHHS as directed.
Ensure documentation and tracking meet contractual, regulatory, and turnaround‑time requirements.
Identify trends, data discrepancies, or training needs and escalate appropriately.
Perform other duties as assigned