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Alignment Health एक स्वास्थ्य बीमा कंपनी है, जिसका उद्देश्य मेडिकेयर सदस्यों—विशेष रूप से वरिष्ठ नागरिकों, दीर्घकालिक स्वास्थ्य समस्याओं के साथ जीवन बिताने वाले लोगों और कमजोर स्वास्थ्य वाले व्यक्तियों—की देखभाल को बेहतर बनाना है। 2013 में स्थापित यह कंपनी व्यक्तिगत देखभाल मॉडल को प्रौद्योगिकी और चौबीसों घंटे उपलब्ध कंसीयर्ज देखभाल टीम के साथ जोड़ती है, ताकि विश्वसनीय स्थानीय प्रदाताओं के साथ सहायता का समन्वय किया जा सके। इसका कार्य स्वास्थ्य सेवा प्रदान करने और बीमा, दोनों क्षेत्रों में फैला है, जिसमें सदस्यों के लिए देखभाल को अधिक सुलभ, तत्पर और लागत-सचेत बनाने पर ध्यान दिया जाता है। Alignment Health एक बढ़ते हुए स्वास्थ्य सेवा संगठन में नियुक्तियां करती है, जो मेडिकेयर समुदायों की आवश्यकताओं को पूरा करता है।
Remote Bilingual Spanish Care Coordinator – Transition of Care
Remote Care Coordinator supporting Alignment Health members with referrals, authorizations, discharges, medications, appointments, and follow-up care. Partners with RN Case Managers across chronic-care programs and advocates for members throughout care transitions.
विवरण
- Contact members by phone to support referrals, authorizations, home health care, durable medical equipment, medication refills, provider appointments, and follow-up needs.
- Create cases and tasks and complete Case Management module assessments for hospital and skilled nursing facility discharges.
- Complete and document tasks assigned by the nurse.
- Partner with the Case Manager to engage and manage a panel of SNP members.
- Monitor new alerts and report changes in condition, admissions, discharges, or diagnoses to the Case Manager.
- Build trusting member relationships and serve as a patient advocate.
- Escalate non-compliance concerns and changes in condition to the nurse.
- Support outreach activities across all levels of Case Management Programs.
- Keep member records accurate and current.
- Mail or fax correspondence to members, primary care providers, and specialists.
- Request and upload medical records from primary care providers, specialists, hospitals, and other providers.
- Attend Interdisciplinary Team Meetings and contribute to member presentations when appropriate.
- Meet deadlines and prioritize work according to department policies, standards, and operational needs.
- Protect confidential information shared among health care professionals.
- Perform additional duties assigned by the CM Supervisor, Manager, or Director of Care Management.
आवश्यकताएँ
- At least one year of experience working in health care IPAs.
- At least one year of experience entering referrals and prior authorizations.
- High school diploma or GED; a bachelor’s degree or four additional years of experience may substitute for the education requirement.
- Ability to read and interpret safety rules, operating and maintenance instructions, and procedure manuals.
- Ability to prepare routine reports and correspondence.
- Strong customer service and communication skills.
- Ability to communicate positively, professionally, and effectively while providing leadership, teaching, and collaboration.
- Strong problem-solving, organizational, and time-management skills.
- Ability to work effectively in a fast-paced environment.
- Knowledge of managed care plans.
- Knowledge of Medi-Cal.
- Basic computer proficiency and typing speed of 25 words per minute.
- Proficiency with Microsoft Outlook, Excel, and Word.
- Basic mathematical and reasoning skills.
- Bilingual proficiency in English and Spanish.
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