Alignment Health is seeking a Care Coordinator to join our Care Anywhere Program, supporting field providers and managing care coordination for high-risk members. This is a remote, bilingual (Spanish) role based in California.
What You'll Do
- Manage four provider schedules to ensure schedules are filled.
- Prepare charts for upcoming home visit appointments, checking member eligibility and gathering required records.
- Conduct outreach for scheduling, appointment confirmation calls, and wellness checks for high-risk members.
- Handle 60-80 inbound and outbound calls per day.
- Obtain medical records from provider offices, hospitals, and skilled nursing facilities and upload them to the EMR.
- Submit referral authorizations to IPA/medical groups for specialty, durable medical equipment, and home health services.
- Coordinate lab orders and transportation for high-risk members.
- Document all inbound and outbound calls via the electronic medical record system.
- Support SMS and member outreach campaigns.
- Assist the nurse practitioner team with visit preparation needs.
- Send appointment reminders to members.
- Assign members to NPs in the EHR.
- Provide needed documentation to NPs for daily visits.
- Direct inbound calls from members and family related to medication refills.
- Assist with maintaining and updating members' records.
- Assist with mailing or faxing correspondence to PCPs and specialists as needed.
- Attend Care Anywhere meetings and presentations and participate as appropriate.
- Recognize work-related problems and contribute to solutions.
- Work with outside vendors to provide appropriate care needs for members.
What We're Looking For
- Minimum 1 year experience entering referrals and prior authorizations in a healthcare setting.
- High School Diploma or GED.
- Able to communicate positively, professionally, and effectively with others; provide leadership, teach, and collaborate.
- Knowledge of ICD9 and CPT codes.
- Knowledge of Managed Care Plans.
- Able to type by 10-key touch a minimum of 40 words per minute.
- Proficient with Microsoft Outlook, Excel, and Word.
- Effective written and verbal communication skills.
- Able to read and interpret documents such as safety rules and procedure manuals.
- Able to write routine reports and correspondence.
- Communicates effectively using good customer relations skills.
- Possesses basic arithmetic skills.
- Able to apply common sense understanding to carry out detailed instructions.
- Able to deal with problems involving a few concrete variables in standardized situations.
- Effective problem-solving, organizational, and time management skills.
- Bilingual English/Spanish required.
Nice to Have
- 2 years' healthcare experience.
- Completion of a medical assistant program from an accredited school.
- Medical Terminology training.
- Knowledge working in Athena.
- Medical assistant certificate.
- Medical terminology certificate.
Technical Stack
- Microsoft Outlook
- Microsoft Excel
- Microsoft Word
- Electronic Medical Records (EMR)
- Athena (preferred)
Team & Environment
You will join our remote Care Anywhere team in a collaborative environment passionate about transforming the lives of seniors. We are committed to serving seniors and the chronically ill, with a mission to put the senior first. There's ample room for growth and innovation.
Benefits & Compensation
- Compensation: $41,472.00 - $62,208.00
Work Mode
This is a remote position for candidates located in California.
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.
