Remote Care Coordinator, SNP (Bilingual Spanish Preferred))

Alignment Health • Remote CA Outside Bay Area, CA

2d • $41,472 - $62,208 • Remote

About The Position

Alignment Health is seeking a remote care coordinator (Bilingual: Spanish or Vietnamese) to join the special needs program (SNP) case management team. The Care Coordinator works in collaboration with the RN Case Manager as part of the interdisciplinary team. The Remote Care Coordinator supports members with closing care gaps and addressing care coordination needs as directed by the RN Case Manager. The Special Needs Plan (SNP) team is responsible for the health care management and coordination of care for members with complex and chronic care needs.

Requirements

• Minimum 1 year experience working in Health Care IPAs.
• Minimum 1 year experience entering referrals and prior authorizations.
• High School Diploma or GED.
• Ability 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.
• Ability 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
• Basic Computer Skills, 25 WPM (Microsoft Outlook, excel, word)
• Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s.
• Ability to perform these operations using units of American money and weight measurement, volume, and distance.
• Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
• Ability to deal with problems involving a few concrete variables in standardized situations.
• None

Nice To Haves

• Bachelor's degree or four years additional experience in lieu of education.
• Medical Assistant training, Medical Terminology training.
• Bilingual: Spanish or Vietnamese
• Medical Assistant Certificate, Medical Terminology Certificate

Responsibilities

• Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc.
• Creates cases, tasks, and completes assessments in 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 SNP members
• Manages new alerts and updates Case Manager of change in condition, admission, discharge, or new diagnosis
• Establishes relationships with members, earns their trust and acts as patient advocate
• Escalates concerns to nurse if members appear to be non-compliant or there appears to be a change in condition
• Assists with outreach activities to members in all levels of Case Management Programs.
• Assists with maintaining and updating member’s records
• Assists with mailing or faxing correspondence to members, PCP’s, and/or Specialists
• Requests and uploads medical records from PCP’s, Specialists, Hospitals, etc., as needed
• Attends Interdisciplinary Team Meetings and participates in member presentations as appropriate.
• Meets specific deadlines (responds to various workloads by assigning task priorities 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

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED