Telephonic Care Coordinator (Bilingual Spanish, MA, Remote, Pacific Time)

Alignment Healthcare USA; United States; À distance; USD 42 000 - 65 000; Plein temps

Résumé du poste

Alignment Health in the United States is seeking a bilingual Spanish care coordinator to join the remote Care Anywhere team. The role centers on transitions-of-care (TOC) focused post-discharge outreach with outbound telephonic engagement to members after hospital and SNF discharges.

The position follows a Pacific Time work schedule with two shift options on weekdays. The Care Coordinator will spend most of the day conducting outbound outreach, scheduling timely follow-up care, coordinating

Qualifications

• Minimum 1 year experience in health care settings (Health Plan, Medical office, IPA, MSO).
• Experience conducting high-volume telephonic outreach to patients or members.
• Experience interacting with patients or members and supporting scheduling, outreach, or front-office activities.

Responsabilités

• Conducts high-volume outbound telephonic outreach to members post-discharge.
• Engages members to schedule timely follow-up appointments with Care Anywhere providers.
• Documents outreach, outcomes, and follow-ups in required systems.
• Creates cases and tasks in the Case Management module for discharges.
• Coordinates referrals, authorizations, and other care coordination needs.
• Requests and uploads medical records as needed.
• Maintains confidentiality and works with clinical staff to manage assigned members.

Connaissances

Bilingual Spanish

Communication

Care coordination

Formation

High School Diploma or GED

Medical Assistant program completion

Outils

Case Management system

Description du poste

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 bilingual Spanish care coordinator to join the remote Care Anywhere team. The Care Coordinator supports a transitions-of-care (TOC) focused, post-discharge outreach workstream centered on timely telephonic outreach to members following hospital and skilled nursing facility discharges.

The Care Coordinator will spend most of the workday conducting outbound member outreach. Success in this role requires someone who is comfortable and enjoys speaking with members on the phone throughout the day, consistently completes time-sensitive outreach, and demonstrates strong follow-through, organization, and accountability.

This is a high-volume, phone-based position responsible for engaging members, scheduling timely follow-up care, coordinating identified needs, and completing required documentation.

This position follows a Pacific Time work schedule. Candidates must be available to work one of the schedules below in Pacific Time, regardless of their local time zone.

Schedule:

Mondays - Fridays

• Option 1: 8:00 AM - 5:00 PM Pacific Time (with 1-hour lunch)
• Option 2: 8:30 AM - 5:30 PM Pacific Time (with a 30-minute lunch)

General Duties / Responsibilities:

• Conducts high-volume outbound telephonic outreach to members following Hospital and SNF discharges.
• Follows established, time-sensitive outreach protocols and consistently completes required outreach attempts and follow-up activities.
• Engages members telephonically to assist with scheduling timely follow-up appointments with Care Anywhere providers and other appropriate healthcare resources.
• Uses established scripts and questionnaires to guide member outreach and accurately capture required information.
• Completes timely and accurate documentation of member outreach, outcomes, and follow-up activities across required systems.
• Creates cases, tasks, and completes documentation in the Case Management module for Hospital and SNF discharges.
• Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, provider appointments and follow-ups, and other care coordination needs as applicable.
• Requests and uploads medical records from Hospitals, SNFs, PCPs, Specialists, and other healthcare providers as needed.
• Complies with tasks assigned by nurse and, as appropriate, documents accordingly.
• Works as a team with clinical and care management staff to engage and manage assigned members.
• Manages new alerts and escalates changes in condition, admission, discharge, new diagnosis, or other clinical concerns to the appropriate clinical team member.
• Establishes relationships with members, earns their trust and acts as patient advocate.
• Assists with outreach activities and provides cross-coverage for other member needs as required based on business needs.
• Assists with maintaining and updating member records.
• Assists with mailing or faxing correspondence to members, PCPs, Specialists, and other healthcare providers as needed.
• Meets specific deadlines and prioritizes workload according to department policies, standards, and member needs.
• Maintains confidentiality of information between and among health care professionals.
• Other duties as assigned by CM Supervisor, Manager or Director of Care Management.

Job Requirements:

Experience:

• Required: Minimum 1 year experience working in Health Care such as Health Plan, Medical office, IPA, MSO. Experience conducting frequent or high-volume telephonic outreach to patients or members. Experience interacting directly with patients or members and supporting healthcare-related scheduling, outreach, or front-office activities.
• Preferred: Experience with transitions of care (TOC), post-discharge outreach, hospital or SNF discharge follow-up, care management, or population health outreach. Experience requesting medical records from Hospitals, SNFs, physician offices, or other healthcare facilities. Experience assisting members/patients with authorizations, referrals, scheduling appointments, identification of resources, or related care coordination activities.

Education:

• Required: High School Diploma or GED.
• Completion of accredited Medical Assistant program.
• Preferred:

Training:

• Required:
• Preferred: Medical Terminology training.

Specialized Skills:

• Required:
• Preferred:

Able and willing to spend most of the workday conducting