About The Position

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 a care coordinator to join the transitions of care case management team. As a care coordinator, you partner closely with an RN case manager to support members through transitions of care, helping ensure they receive timely, coordinated services following hospital or SNF discharge. In this role, the care coordinator works directly with members to schedule appointments, coordinate services such as home health and DME, assist with authorizations, and help close care gaps—playing a key role in improving outcomes for seniors with complex and chronic conditions. This is a highly collaborative, member-facing role ideal for someone with care coordination or case management experience who is comfortable navigating healthcare systems and supporting members telephonically throughout the day. If you are hungry to learn and grow, want to be part of a growing organization, and make a positive impact in the lives of seniors – we’re looking for you!

Requirements

  • Minimum 1 year of experience in care coordination, case management, or transitions of care within a health plan, IPA, MSO, or medical office setting
  • Experience supporting members/patients with scheduling, authorizations, referrals, and coordination of services (e.g., home health, DME, follow-up care)
  • Experience interacting directly with patients/members in a telephonic or care coordination setting
  • High School Diploma or GED and / or (4) years' relevant experience in lieu of education.
  • Bilingual English and Spanish
  • Able 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.
  • Able to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
  • 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
  • Proficient Computer Skills, Able to type 35 WPM by 10-key touch (Microsoft Outlook, Excel, Word)
  • 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.
  • Able to apply common sense understanding to carry out detailed but uninvolved written or verbal instructions. Able to deal with problems involving a few concrete variables in standardized situations.
  • None
  • 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.
  • 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.
  • 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.

Nice To Haves

  • Experience supporting hospital or SNF discharges, including requesting and reviewing discharge summaries
  • Bachelor's degree
  • Medical assistant training, Medical terminology training.
  • Medical assistant certificate, Medical terminology certificate

Responsibilities

  • Create cases, tasks, and complete documentation in the Case Management module for all Hospital and SNF discharges
  • Reach out to members telephonically to assist with referrals, authorizations, home health care (HHC), durable medical equipment (DME), medication refills, and scheduling provider appointments and follow-ups
  • Request and upload medical records from PCPs, specialists, hospitals, and other providers, including discharge summaries
  • Work as a team with the RN Case Manager to engage and manage a panel of members
  • Manage new alerts and update the Case Manager of changes in condition, admission, discharge, or new diagnoses
  • Complete and document tasks assigned by nurse
  • Establish relationships with members, earn their trust, and act as a patient advocate
  • Escalate concerns to nurse if members appear to be non-compliant or there is a change in condition
  • Assist with outreach activities to members across all levels of case management programs
  • Assist with maintaining and updating member records
  • Assist with mailing or faxing correspondence to members, primary care physicians (PCPs), and/or specialists
  • Meet specific deadlines by prioritizing tasks according to department policies, standards, and business needs
  • Maintain confidentiality of information between and among healthcare professionals
  • Other duties as assigned by case management leadership

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

High school or GED

Number of Employees

1-10 employees

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