Case Management Care Coordinator (TEMPORARY) Bilingual in Spanish in Preferred (Location: Orange, California)

Location: Orange, California US

Notice

This position is no longer open.

Job Number: 2754

Workplace Type:

Position Title: Care Coordinator, Case Management

External Description:

Care Coordinator, Case Management

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.

 

Position Summary:
The Case Management 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 members enrolled in Case Management defined below:

 

General Duties/Responsibilities:

(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 documentation in the Case Management module for all Hospital and SNF discharges
  • Complies with tasks assigned by nurse and, as appropriate and documents accordingly
  • Works as a team with the Case Manager to engage and manage a panel of members
  • Manages new alerts and updates Case Manager of changes 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
  • 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

 

Minimum Requirements:

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.

 

  1. Minimum Experience:
    1. Experience working in Health Care such as Health Plan, Medical office, IPA, MSO
    2. Experience assisting members/patients with authorizations, scheduling appointments, identification of resources, etc.
  2. Education/Licensure:
    1. 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
    2. Medical Assistant Certificate Preferred
  3. Other:
    1. Knowledge of Managed Care Plans
    2. Knowledge of Medi-Cal
    1. Basic Computer Skills, 25 WPM (Microsoft Outlook, excel, word)
    2. Bilingual (English/Spanish) preferred
    3. Medical Terminology Certificate preferred
    4. Knowledge working in Access Express/Portal, epic, Essette (not mandatory)
    5. Good oral, written and telephone skills
    6. 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.
    7. 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.
    8. 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.
    9. Computer Skills:  Basic skills required.
    10. Good organizational skills
    11. Ability to reason and carry out instructions
    12. Good interpersonal skills
    13. Read, write and speak English fluently
    14. File systematically
  1. Work Environment
    1. 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.

 

  1. 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.
  2. 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 [email protected].

City: Remote-Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Case Management Care Coordinator (TEMPORARY) Bilingual in Spanish in Preferred (Location: Orange, California)

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

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.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].