
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.
🔥 3 minutes ago
🇺🇸 United States – Remote
💵 $41.5k - $62.2k / year
⏰ Full Time
🟢 Junior
💬 Bilingual
🚫👨🎓 No degree required
👻 Ghost score 0%
🗣️🇪🇸 Spanish Required
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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.
• 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 regarding non-compliance or changes in condition • Assist with outreach activities for members in all levels of Case Management Programs • Maintain and update member records • Mail or fax correspondence to members, PCPs, and specialists • Request and upload medical records from PCPs, specialists, hospitals, and other providers • Attend Interdisciplinary Team Meetings and participate in member presentations as appropriate • Meet 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
• Minimum 1 year experience working in Health Care IPAs • Minimum 1 year experience entering referrals and prior authorizations • High School Diploma or GED; Bachelor's degree or four years 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 customer relations and communication 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 • Basic mathematical and reasoning skills • Bilingual in English and Spanish
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