Alignment Health is seeking an organized, detail oriented, and compassionate remote care coordinator, chronic kidney disease (CKD) to join the Care Anywhere team for a long-term temporary engagement (with medical benefits.) As a care coordinator, you are responsible for UM / CM Coordinator functions as defined below. If you have experience as a front office medical assistant, want to be part of a growing organization, are hungry to learn and grow, and make a positive impact in the lives of seniors - we're looking for you!
Please note: Alignment Health is continuing to expand so there is a possibility the engagement could extend or convert based on budget, business need, and individual performance.
Responsibilities:
Conduct calls to nephrology clinics, primary care physician (PCP) offices, and dialysis facilities. (75% of the position is making calls, and asking hard questions regarding treatment, comfortable with speaking with Physicians)
Able to research and update labs from Quest, hospital notes, or other sources for accurate CKD stage.
Review daily census for new admissions
Obtain medical records from provider offices, hospitals, and skilled nursing facilities (SNF)
Attach medical records to authorizations
Monitor fax folders
Follow up scheduling and re-scheduling of no-show appointments
Assist nurse practitioner (NP) team with visit preparation needs
Appointment reminders to members
Assign members to NP in EHR
Enter all medications and allergies in electronic health record (EHR)
Provide needed documentation to NP for visits each day
Maintain documentation on members contacted.
Notify NP / 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 PCP's, specialists, related to, as needed.
Attends case management presentations and participates, as appropriate.
Recognize work-related problems and contribute to solutions.
Meet specific deadlines by responding to various workloads, assigning task priorities according to department policies, standards, and needs
Work with outside vendors to provide appropriate care needs for members
Maintain confidentiality of information between and among health care professionals.
Communicate with multidisciplinary teams
Cover for other team members when needed (i.e. PTO, sick time)
Required Skills and Experience:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum 1 year front office medical assistant, related experience, and / or training; or equivalent combination of education and experience.
Experience entering referrals and prior authorizations (highly preferred)
High school diploma or general education degree (GED)
Medical Terminology Certificate preferred
Knowledge of medical terminology
Knowledge of ICD-9 and CPT codes
Knowledge of managed care plans
Computer proficient
Able to type minimum 40 words per minute (WPM)
Proficient in Microsoft Office (Outlook, Excel, Word)
Knowledge working in Access Express / Portal, Epic, Essette preferred
Read, write, and speak English fluently.
Bilingual English and either Spanish or Vietnamese required.
Strong written, verbal, and telephonic communication skills.
Able to reason and carry out instructions.
Good interpersonal skills.
Good organizational skills.
File systematically..
Language Skills: Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Communicates effectively using good customer relations skills.
Mathematical Skills: Able to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Able to perform these operations using units of American money and weight measurement, volume, and distance.
Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
