Bilingual Care Coordinator, Transition of… at Alignment… · California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. 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 Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Alignment Health is seeking a care coordinator to join the transitions of care case management team. As a care coordinator, you partner closely with an RN case manager to support members through transitions of care, helping ensure they receive timely, coordinated services following hospital or SNF discharge.

In this role, the care coordinator works directly with members to schedule appointments, coordinate services such as home health and DME, assist with authorizations, and help close care gaps—playing a key role in improving outcomes for seniors with complex and chronic conditions.

This is a highly collaborative, member-facing role ideal for someone with care coordination or case management experience who is comfortable navigating healthcare systems and supporting members telephonically throughout the day.

If you are hungry to learn and grow, want to be part of a growing organization, and make a positive impact in the lives of seniors – we’re looking for you!

Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time (flexible start between 7:30 AM – 8:30 AM). No overtime required. Location: Fully Remote (must be based in California or Pacific Time Zone)

GENERAL DUTIES / RESPONSIBILITIES:

• Create cases, tasks, and complete documentation in the Case Management module for all Hospital and SNF discharges
• Reach out to members telephonically to assist with referrals, authorizations, home health care (HHC), durable medical equipment (DME), medication refills, and scheduling provider appointments and follow-ups
• Request and upload medical records from PCPs, specialists, hospitals, and other providers, including discharge summaries
• Work as a team with the RN Case Manager to engage and manage a panel of members
• Manage new alerts and update the Case Manager of changes in condition, admission, discharge, or new diagnoses
• Complete and document tasks assigned by nurse
• Establish relationships with members, earn their trust, and act as a patient advocate
• Escalate concerns to nurse if members appear to be non-compliant or there is a change in condition
• Assist with outreach activities to members across all levels of case management programs
• Assist with maintaining and updating member records
• Assist with mailing or faxing correspondence to members, primary care physicians (PCPs), and/or specialists
• Meet specific deadlines by prioritizing tasks according to department policies, standards, and business needs
• Maintain confidentiality of information between and among healthcare professionals
• Other duties as assigned by case management leadership

Job Requirements:

Experience:

Required:

• Minimum 1 year of experience in care coordination, case management, or transitions of care within a health plan, IPA, MSO, or medical office setting
• Experience supporting members/patients with scheduling, authorizations, referrals, and coordination of services (e.g., home health, DME, follow-up care)
• Experience interacting directly with patients/members in a telephonic or care coordination setting

Preferred:

• Experience supporting hospital or SNF discharges, including requesting and reviewing discharge summaries

Education:

• Required: High School Diploma or GED and / or (4) years' relevant experience in lieu of education.

• Preferred: Bachelor's degree

Training:

• Required:

• Preferred: Medical assistant training, Medical terminology training.

Specialized Skills:

Required:

• Bilingual English and Spanish
• Able 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.
• Able to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Problem-Solving Skills: 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
• Proficient Computer Skills, Able to type 35 WPM by 10-key touch (Microsoft Outlook, Excel, Word)
• Mathematical Skills: Able to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Able to perform these operations using units of American money and weight measurement, volume, and distance.
• Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or verbal instructions. Able to deal with problems involving a few concrete variables in standardized situations.

Licensure:

• Required: None

• Preferred: Medical assistant certificate, Medical terminology certificate

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.

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.

Pay Range: $41,472.00 - $62,208.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

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 careers@ahcusa.com.