Medicare Services & Aging Coordinator

AltaMed•Commerce, CA

3d•$25 - $29

About The Position

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Job Overview The Medicare Services Coordinator will provide member-centric services to Medicare/Medi-Cal senior patients, including newly enrolled members of senior plans. Providing a high-touch problem resolution approach, the coordinator is responsible for incoming calls, outbound calls, and initiatives that increase problem resolution, engagement, and retention. The coordinator is responsible for screening patient needs, answering patient questions, scheduling, and documenting services. The Medicare Services Coordinator is the point of contact for an in-depth orientation and services coordination in the first 45 days following newly enrollee assignments including making welcome calls, explaining and providing coordination of the health plan benefits and services available,; providing explanation of plan benefits, identifying service needs such as transportation to and from appointments and removing barriers for health care access. This position offers coordination of services required by regulation such as Health Risk Assessment/Medicare Health Assessment, identification of problem areas or concerns, appropriate interventions/services to be arranged, any additional plan specific requirements and maintaining a comprehensive and progressive record in EHR and CRM of all coordination activities including need for escalating problems or issues. Responsibilities include liaising with providers and staff responsible for coordinating follow-up and ensuring systematic check-ins with the members as needed. This position will require providing warm hand-offs with assistance services and identifying opportunities to improve efficiencies and customer service. The Medicare Services Coordinator ensures the best member experience possible from beginning to end.

Requirements

High School diploma or equivalent required.
Minimum 3 years’ experience working in a healthcare customer service/care coordination environment; knowledge of plan benefits and regulations governing Medi-Cal, Commercial, Medicare, and other government and commercial programs.
Minimum 3 years of experience in a managed health care environment, preferably IPA, HMO, or Health Plan, preferred, in addition to experience working with an ethnically diverse population.
Bilingual English/Spanish required.

Nice To Haves

Bachelor's in social work (or related field) with senior plans and patient-centric experience, or Medical Assistant or LVN desirable.

Responsibilities

Provide member-centric services to Medicare/Medi-Cal senior patients, including newly enrolled members of senior plans.
Provide a high-touch problem resolution approach
Responsible for incoming calls, outbound calls, and initiatives that increase problem resolution, engagement, and retention.
Responsible for screening patient needs, answering patient questions, scheduling, and documenting services.
Point of contact for an in-depth orientation and services coordination in the first 45 days following newly enrollee assignments including making welcome calls, explaining and providing coordination of the health plan benefits and services available
Provide explanation of plan benefits, identifying service needs such as transportation to and from appointments and removing barriers for health care access.
Coordination of services required by regulation such as Health Risk Assessment/Medicare Health Assessment, identification of problem areas or concerns, appropriate interventions/services to be arranged, any additional plan specific requirements and maintaining a comprehensive and progressive record in EHR and CRM of all coordination activities including need for escalating problems or issues.
Liaising with providers and staff responsible for coordinating follow-up and ensuring systematic check-ins with the members as needed.
Providing warm hand-offs with assistance services and identifying opportunities to improve efficiencies and customer service.
Ensures the best member experience possible from beginning to end.