Remote Care Coordinator,Transition of Care,Bilingual Spanish Job California Missouri USA,Healthcare

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.

In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Care Coordinator works in collaboration with the RN Case Manager as part of the interdisciplinary team. The Care Coordinator supports members with closing care gaps and addressing care coordination needs as directed by the RN Case Manager.

General Duties/Responsibilities (May Include But Are Not Limited To):

Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc.

Creates cases, tasks, and completes assessments in Case Management module for all Hospital and SNF discharges

Complies with tasks assigned by nurse and, as appropriate, documents accordingly

Works as a team with the Case Manager to engage and manage a panel of SNP members

Manages new alerts and updates Case Manager of change in condition, admission, discharge, or new diagnosis

Establishes relationships with members, earns their trust and acts as patient advocate

Escalates concerns to nurse if members appear to be non-compliant or there appears to be a change in condition

Assists with outreach activities to members in all levels of Case Management Programs.

Assists with maintaining and updating member’s records

Assists with mailing or faxing correspondence to members, PCP’s, and/or Specialists

Requests and uploads medical records from PCP’s, Specialists, Hospitals, etc., as needed

Attends Interdisciplinary Team Meetings and participates in member presentations as appropriate.

Meets specific deadlines (responds to various workloads by assigning task priorities according to department policies, standards and needs)

Maintains confidentiality of information between and among health care professionals

Other duties as assigned by CM Supervisor, Manager or Director of Care Management

Job Requirements:

Experience:

Required:

Minimum 1 year experience working in Health Care IPAs. Minimum 1 year experience entering referrals and prior authorizations.
Preferred:

Education:
Required:

High School Diploma or GED. Bachelor's degree or four years additional experience in lieu of education.
Preferred: MBA Training:
Required:
Preferred:
Medical Assistant training, Medical Terminology training.

Specialized

Skills:

Required:

Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Communicates effectively using good customer relations skills.
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Problem-Solving

Skills:

Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Knowledge of Managed Care Plans
Knowledge of Medi-Cal
Basic Computer Skills, 25 WPM (Microsoft Outlook, excel, word)
Mathematical

Skills:

Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
Reasoning

Skills:

Ability to apply common sense understanding to carry out…

Remote Care Coordinator, Transition of Care, Bilingual Spanish