Alignment Healthcare is a population health management company dedicated to changing the way health care is delivered in the United States. We are a fast-growing, highly dynamic organization that isn’t content with the status quo. We are looking for dedicated, innovative individuals who thrive in a fast-paced environment to join our team and help us carry out our vision - that is, to lead a movement that transformationally improves health care.

Join us today and we will give you every opportunity to succeed.

Case Manager (Temporary)

Location: Orange, California US

Notice

This position is no longer open.

Job Number: 1582

Position Title: Case Manager

External Description:

Alignment Healthcare is seeking a case manager (temporary) for the Care Anywhere team to provide health care management and coordination within the scope of licensure for Alignment Healthcare members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.

As a case manager, you will be coordinating and monitoring member progress and services to ensure consistent cost-effective care that complies with Alignment policy and all state and federal regulations and guidelines, as well as facilitate discharge planning from hospital / skilled nursing facility (SNF) to home, hospital to SNF as needed. Most duties for this role are performed telephonically.

General Duties/Responsibilities:
(May include but are not limited to)

  • Assess member current health status, resource utilization, past and present treatment plan and services.
  • Collaborate with member, primary care physicians (PCP) and care team to develop a plan of care.
  • Monitor and evaluate effectiveness of the care management plan and modify as needed.
  • Provide education and self-management support based on the patient’s unique learning style.
  • Monitor and evaluate effectiveness of the care management plan and modify as needed.
  • Interface with PCP, hospitalists, nurse practitioners, and specialists on the development of care management treatment plans.
  • Ensure access to appropriate care for members with urgent or immediate needs.
  • Facilitate authorizations / referrals as appropriate within benefits structure or through extra-contractual arrangements.
  • Assist with discharge planning for high risk population.
  • Assist in problem solving with providers, claims, or service issues.
  • Other duties based on supervisor request / need.

Supervisory Responsibilities:
None.

Minimum Requirements:

Minimum Experience:

  • 3 years' clinical case management experience; or any combination of education and experience, which would provide an equivalent background.

Education / Licensure:

  • Current, unrestricted RN license in California

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.

  • 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.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Case Manager (Temporary)

Company Profile:

Who is Alignment Healthcare?

  • Socially responsible
  • Technologically enabled
  • Concierge care
  • Transformation
  • Servant leadership

We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.

We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.

EEO Employer Verbiage:

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.

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