Care Coordinator, SNP – Bilingual Spanish Preferred

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

🛡️ Insurance

🏥 Healthcare

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Reach out to members by telephone to assist with referrals, authorizations, HHC, DME needs, medication refills, provider appointments, and follow-ups • Create cases and tasks and complete assessments in the Case Management module for Hospital and SNF discharges • Complete tasks assigned by the nurse and document accordingly • Work with the Case Manager to engage and manage a panel of SNP members • Manage new alerts and update the Case Manager regarding changes in condition, admissions, discharges, or new diagnoses • Establish relationships with members, earn their trust, and act as a patient advocate • Escalate concerns to the nurse when members appear non-compliant or show a change in condition • Assist with outreach activities to members in all levels of Case Management Programs • Maintain and update member records • Mail or fax correspondence to members, PCPs, and/or specialists • Request and upload medical records from PCPs, specialists, hospitals, and other sources • Attend Interdisciplinary Team Meetings and participate in member presentations as appropriate • Meet specific deadlines and prioritize tasks according to department policies, standards, and needs • Maintain confidentiality of information among health care professionals • Perform other duties assigned by the CM Supervisor, Manager, or Director of Care Management

🎯 Requirements

• Minimum 1 year of experience working in Health Care IPAs • Minimum 1 year of experience entering referrals and prior authorizations • High School Diploma or GED required • Bachelor's degree or four years of additional experience in lieu of education • Ability to read and interpret safety rules, operating and maintenance instructions, and procedure manuals • Ability to write routine reports and correspondence • Effective communication and customer relations skills • Ability to communicate positively, professionally, and effectively; provide leadership, teach, and collaborate • Effective problem-solving, organizational, and time management skills • Ability to work in a fast-paced environment • Knowledge of Managed Care Plans • Knowledge of Medi-Cal • Basic computer skills and typing speed of 25 WPM • Proficiency with Microsoft Outlook, Excel, and Word • Ability to add, subtract, multiply, and divide using American money, weight, volume, and distance measurements • Ability to apply common-sense understanding to detailed written or oral instructions • Ability to deal with problems involving a few concrete variables in standardized situations • Bilingual Spanish or Vietnamese preferred • Medical Assistant training and Medical Terminology training preferred • Medical Assistant Certificate and Medical Terminology Certificate preferred • No licensure required • Ability to meet the stated physical functions, including talking, hearing, standing, walking, sitting, handling objects, reaching, and frequently lifting/moving up to 10 pounds