Location: Remote-US, California US
Job Number7150
Workplace Type:Fully Remote
Remote-US,California
Alignment Health is revolutionizing health care for seniors by leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?
At Alignment Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.
***Please note, the job posting represents a future opportunity and it is not an immediate need.***
Overview of the Role:
Alignment Health is seeking a bilingual Spanish remote care coordinator to join the special needs plan (SNP) case management team. The SNP team is responsible for the health care management and coordination of care for members with complex and chronic care needs. As a care coordinator, will be responsible for case management coordinator functions for the SNP membership and get to support members with closing care gaps and addressing care coordination needs as directed by the RN Case Manager. You will collaborate with the RN case manager as part of the interdisciplinary team.
If you have experience as a front office medical assistant, want to be part of a growing organization, are hungry to learn and grow, and make a positive impact in the lives of seniors – we’re looking for you!
Responsibilities:
- Reach out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc
- Create cases, task, and complete assessments in case management module for all hospital and SNF discharges
- Complete and document tasks assigned by case manager.
- Work as a team with the case manager to engage and manage a panel of SNP members
- Manage new alerts and update case manager of change in condition, admission, discharge, or new diagnosis
- Establish relationships with members, earn their trust, and act as patient advocate
- Escalate concerns to nurse if members appear to be non-compliant or there appears to be a change in condition
- Assist with outreach activities to members in all levels of case management programs.
- Assist with maintaining and updating member’s records
- Assist with mailing or faxing correspondence to members, PCP’s, and/or Specialists
- Request and upload medical records from PCP’s, Specialists, Hospitals, etc., as needed
- Attend interdisciplinary team meetings and participate in member presentations as appropriate.
- Meet specific deadlines (respond to various workloads by assigning task priorities according to department policies, standards and needs)
- Maintain confidentiality of information between and among health care professionals
Required Skills and Experience:
- Experience working with IPAs
- Experience entering referrals and prior authorizations
- Experience with Access Express / Portal, Epic, Essette preferred
- Knowledge of Managed Care Plans
- Knowledge of Medi-Cal
- High school diploma or general education degree (GED); with one to three months related experience and / or training; or equivalent combination of education and experience
- Medical Assistant Certificate Preferred
- Medical Terminology Certificate preferred
- Organized and detail oriented
- Proficient computer skills, 25 WPM (Microsoft Outlook, Excel, Word)
- Read, write, and speak English fluently
- Bilingual English / Spanish highly preferred (willing to consider Bilingual Vietnamese)
- Good interpersonal skills
- Good verbal, written, and telephonic skills
- Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Communicates effectively using good customer relations skills. Able to file systematically
- Able to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Able to perform these operations using units of American money and weight measurement, volume, and distance.
- Able to apply common sense understanding to carry out detailed but uninvolved written or verbal instructions. Able to deal with problems involving a few concrete variables in standardized situations. Able to reason and carry out instructions.
PAY RANGE: $39,900.00-$52,000.00 annually
Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/.
