Remote Care Coordinator for Seniors | Case Management

Alignment Health; Orange (CA); Remote; USD 41,000 - 62,000; Full time

Job summary

Alignment Health is seeking a compassionate, customer service oriented and organized care coordinator to join the remote outpatient case management team. The role works alongside the RN case manager and interdisciplinary team to coordinate services, close care gaps, and ensure seniors receive timely, appropriate care.

You’ll help coordinate services, assist with referrals, authorizations, scheduling, and navigating care plans, with bilingual Spanish highly preferred.

Qualifications

• Read and interpret safety rules and procedure manuals.
• Write routine reports and correspondence.
• Communicate effectively with members and providers.
• Ability to read, interpret, and follow clinical instructions.
• Bilingual English and Spanish preferred.

Responsibilities

• Reach out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups.
• Create cases, tasks, and complete documentation in the case management module for all hospital and skilled nursing facility (SNF) discharges
• Comply and document tasks assigned by nurse
• Work as a team, in this fully remote role, with the case manager to engage and manage a panel of members
• Manage new alerts and update case manager on changes in condition, admission, discharge, or new diagnosis
• Establish relationships with members, earn their trust and act as patient advocate
• Escalate concerns to nurse if members appear to be non-compliant or there appears to be a change in condition
• Assist with outreach activities to members in all levels of case management programs
• Assist with maintaining and updating members' records
• Assist with mailing or faxing correspondence to members, primary care physicians (PCP), and / or Specialists
• Request and upload medical records from PCP’s, specialists, hospitals, etc.
• Meet specific deadlines (respond to various workloads by assigning task priorities according to department policies, standards, and needs)
• Maintain confidentiality of information between and among health care professionals
• Other duties as assigned by case manager (CM) supervisor, manager or director of care management

Skills

Customer service

Bilingual Spanish

Communication skills

Managed Care knowledge

Education

High School Diploma or GED

Bachelor's degree or 4 years experience

Tools

Microsoft Office

Case management software

Job description

Alignment Health is seeking a compassionate, customer service oriented and organized care coordinator to join the remote outpatient case management team. The role works alongside the RN case manager and interdisciplinary team to coordinate services, close care gaps, and ensure seniors receive timely, appropriate care.

You’ll help coordinate services, assist with referrals, authorizations, scheduling, and navigating care plans, with bilingual Spanish highly preferred.