Alignment Health
Care Coordinator, Case Management (Temporary)
Alignment Health, Orange, California, United States, 92613
Overview
Alignment Health is seeking a remote care coordinator to join the case management team for a long-term temporary engagement (with medical benefits). 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. As part of the Case Management team, the Care Coordinator is responsible for the health care management and coordination of care for members with complex and chronic care needs. The Care Coordinator performs CM Coordinator functions for the members enrolled in Case Management. Schedule
Monday - Friday, 8:00 AM - 5:00 PM Pacific Time Responsibilities
Reaches out to members telephonically to assist with referrals, authorizations, home health care (HHC), DME needs, medication refills, provider appointments and follow ups, etc. Creates cases, tasks, and completes documentation in the 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 members. Manages new alerts and updates the Case Manager on changes in condition, admission, discharge, or new diagnosis. Establishes relationships with members, earns their trust, and acts as a patient advocate. Escalates concerns to the nurse if members appear to be non-compliant or there is a change in condition. Assists with outreach activities to members in all levels of Case Management Programs. Assists with maintaining and updating member records. Assists with mailing or faxing correspondence to members, PCPs, and/or specialists. Requests and uploads medical records from PCPs, Specialists, Hospitals, etc., as needed. Meets specific deadlines and prioritizes tasks 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. Qualifications
Experience
Required: Minimum 1 year experience in health care such as Health Plan, Medical office, IPA, MSO. Minimum 1 year experience assisting members/patients with authorizations, scheduling appointments, and resource identification. Preferred: none specified. Education
Required: High School Diploma or GED. Bachelors degree or four years additional experience in lieu of education. Preferred: MBA. Training
Required: None specified. Preferred: Medical Assistant training, Medical Terminology training. Specialized Skills
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Effective customer relations and communication skills. Professional and positive communication; ability to lead, teach, and collaborate with others. Problem-solving, organizational, and time-management skills; ability to work in a fast-paced environment. Knowledge of Managed Care Plans and Medi-Cal. Basic computer skills (Microsoft Outlook, Excel, Word); 25 WPM typing. Mathematical and reasoning skills appropriate for the role. Preferred: Bilingual (English/Spanish). Licensure
Required: None Preferred: Medical Assistant Certificate, Medical Terminology Certificate Compensation
Pay Range: $41,472.00 - $62,208.00 per year Equal Opportunity
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. Alignment Health will never ask you for a credit card, a check, or any payment as part of consideration for employment. If you suspect a scam, report it to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ and contact our talent team at careers@ahcusa.com to verify legitimate communications.
#J-18808-Ljbffr
Alignment Health is seeking a remote care coordinator to join the case management team for a long-term temporary engagement (with medical benefits). 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. As part of the Case Management team, the Care Coordinator is responsible for the health care management and coordination of care for members with complex and chronic care needs. The Care Coordinator performs CM Coordinator functions for the members enrolled in Case Management. Schedule
Monday - Friday, 8:00 AM - 5:00 PM Pacific Time Responsibilities
Reaches out to members telephonically to assist with referrals, authorizations, home health care (HHC), DME needs, medication refills, provider appointments and follow ups, etc. Creates cases, tasks, and completes documentation in the 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 members. Manages new alerts and updates the Case Manager on changes in condition, admission, discharge, or new diagnosis. Establishes relationships with members, earns their trust, and acts as a patient advocate. Escalates concerns to the nurse if members appear to be non-compliant or there is a change in condition. Assists with outreach activities to members in all levels of Case Management Programs. Assists with maintaining and updating member records. Assists with mailing or faxing correspondence to members, PCPs, and/or specialists. Requests and uploads medical records from PCPs, Specialists, Hospitals, etc., as needed. Meets specific deadlines and prioritizes tasks 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. Qualifications
Experience
Required: Minimum 1 year experience in health care such as Health Plan, Medical office, IPA, MSO. Minimum 1 year experience assisting members/patients with authorizations, scheduling appointments, and resource identification. Preferred: none specified. Education
Required: High School Diploma or GED. Bachelors degree or four years additional experience in lieu of education. Preferred: MBA. Training
Required: None specified. Preferred: Medical Assistant training, Medical Terminology training. Specialized Skills
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Effective customer relations and communication skills. Professional and positive communication; ability to lead, teach, and collaborate with others. Problem-solving, organizational, and time-management skills; ability to work in a fast-paced environment. Knowledge of Managed Care Plans and Medi-Cal. Basic computer skills (Microsoft Outlook, Excel, Word); 25 WPM typing. Mathematical and reasoning skills appropriate for the role. Preferred: Bilingual (English/Spanish). Licensure
Required: None Preferred: Medical Assistant Certificate, Medical Terminology Certificate Compensation
Pay Range: $41,472.00 - $62,208.00 per year Equal Opportunity
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. Alignment Health will never ask you for a credit card, a check, or any payment as part of consideration for employment. If you suspect a scam, report it to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ and contact our talent team at careers@ahcusa.com to verify legitimate communications.
#J-18808-Ljbffr