Anywhere in the U.S.
Remote only
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.
Alignment Health is seeking an compassionate, customer service oriented, and organized, care coordinator (bilingual Spanish highly preferred) to join the remote outpatient case management team.GENERAL DUTIES / RESPONSIBILITIES:
1. Reach out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc.
2. Create cases, tasks, and complete documentation in the case management module for all hospital and skilled nursing facility (SNF) discharges
3. Comply and document tasks assigned by nurse
4. Work as a team, in this fully remote role, with the case manager to engage and manage a panel of members
5. Manage new alerts and update case manager on changes in condition, admission, discharge, or new diagnosis
6. Establish relationships with members, earn their trust and act as patient advocate
7. Escalate concerns to nurse if members appear to be non-compliant or there appears to be a change in condition
8. Assist with outreach activities to members in all levels of case management programs
9. Assist with maintaining and updating members' records
10. Assist with mailing or faxing correspondence to members, primary care physicians (PCP), and / or Specialists
11. Request and upload medical records from PCP’s, specialists, hospitals, etc.
12. Meet specific deadlines (respond to various workloads by assigning task priorities according to department policies, standards, and needs)
13. Maintain confidentiality of information between and among health care professionals
14. Other duties as assigned by case manager (CM) supervisor, manager or director of care management.
Job Requirements:
Experience:
Required:
Minimum (1) year experience working in health care such as health plan, medical office, Independent Practice Association (IPA), Management Services Organization
Minimum (1) year experience assisting members / patients with authorizations, scheduling appointments, identification of resources, etc.
• Preferred:
Education:
• Required: High School Diploma or GED.
• Preferred: Bachelor's degree or four years additional experience in lieu of education.
Training:
• Required:
• Preferred: Medical assistant training, medical terminology training.
Specialized Skills:
• Required:
Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
Able to write routine reports and correspondence. Communicate effectively using customer relations skills.
Able 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 able to work in a fast-paced environment.
Knowledge of Managed Care Plans
Knowledge of Medi-Cal
Basic computer proficiency, type a minimum 35 words per minute (WPM), proficient in Microsoft Office suite (Outlook, Excel, Word)
Mathematical Skills: 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.
Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations.
• Preferred: Bilingual English and Spanish
Licensure:
• Required: None
• Preferred: Medical assistant certificate, medical terminology certificate
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Pay Range: $41,472.00 - $62,208.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.
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