Remote Senior Care Coordinator — Bilingual Spanish

Alignment Healthcare USA, LLC in; Orange (CA); Remote; USD 41,000 - 62,000; Full time

Job summary

Alignment Health is seeking a Care Coordinator to assist nurses and case managers in coordinating care for seniors and SNP members. You will handle referrals, authorizations, and follow-ups, create and manage cases, and maintain member records with a focus on timely care delivery.

The role requires experience in health care IPAs, strong communication, and bilingual English/Spanish is a plus. A High School Diploma or GED is required, with a Bachelor’s degree or four years of related experience

Qualifications

• Required: Minimum 1 year experience in Health Care IPAs.
• Required: Minimum 1 year experience entering referrals and prior authorizations.
• Required: High School Diploma or GED. Bachelor's degree or four years additional experience in lieu of education.

Responsibilities

• 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

Skills

Communication skills

Bilingual English/Spanish

Time management

Customer service

Managed Care knowledge

Microsoft Office

Education

High School Diploma or GED

Bachelor’s degree in lieu

MBA training

Tools

Microsoft Outlook

Excel

Word

Job description

Alignment Health is seeking a Care Coordinator to assist nurses and case managers in coordinating care for seniors and SNP members. You will handle referrals, authorizations, and follow-ups, create and manage cases, and maintain member records with a focus on timely care delivery.

The role requires experience in health care IPAs, strong communication, and bilingual English/Spanish is a plus. A High School Diploma or GED is required, with a Bachelor’s degree or four years of related experience