Care Coordinator, SNP
Location: Orange, California US
Job Number: 2510
Position Title: Care Coordinator, SNP
Care Coordinator, SNP
Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.
By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. 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 community.
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. The Care Coordinator works in collaboration with the RN Case Manager as part of the interdisciplinary team. The Care Coordinator supports members with closing care gaps and addressing care coordination needs as directed by the RN Case Manager.
The Care Coordinator is responsible for CM Coordinator functions for the SNP membership as defined below:
(May include but are not limited to)
- 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
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Minimum Experience:
- Experience working with IPAs
- Experience entering referrals and prior authorizations
- High school diploma or general education degree (GED); with one to three months related experience and/or training; or equivalent combination of education and experience
- Medical Assistant Certificate Preferred
- Knowledge of Managed Care Plans
- Knowledge of Medi-Cal
- Basic Computer Skills, 25 WPM (Microsoft Outlook, excel, word)
- Bilingual (English/Spanish) preferred
- Medical Terminology Certificate preferred
- Knowledge working in Access Express/Portal, epic, Essette (not mandatory)
- Good oral, written and telephone skills
- Language Skills: 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.
- Mathematical Skills: 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.
- Reasoning Skills: 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.
- Computer Skills: Basic skills required.
- Good organizational skills
- Ability to reason and carry out instructions
- Good interpersonal skills
- Read, write and speak English fluently
- File systematically
- 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.
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.
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 firstname.lastname@example.org.
Location City: Orange
Location State: California
Community / Marketing Title: Care Coordinator, SNP
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- 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.