Care Coordinator, Chronic Kidney Disease (CKD)

Location: Remote-US, California US

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Job Number: 4825

Position Title: Care Coordinator, CKD

External Description:

The Care Coordinator is responsible for UM/CM Coordinator functions as defined below.

General Duties/Responsibilities
(May include but are not limited to):

  • Daily calls to Nephrology clinics, PCP offices, and dialysis facilities. (75% of the position is making calls, and asking hard questions regarding treatment, I need someone who is comfortable with speaking with Physicians)
  • Ability 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 SNF’s
  • Attach medical records to authorizations
  • Monitor Fax Folders
  • Follow up scheduling and re-scheduling of no-show appointments
  • Assist NP team with visit preparation needs
    • Appointment reminders to members
    • Assign members to NP in EHR
    • Enter all medications and allergies in EHR
    • Provide needed documentation to NP for visits each day
  • Maintains documentation on members contacted.
  • Notifies NP/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 PCP’s, Specialists, related to, as needed.
  • Attends Case Management presentations and participates, as appropriate.
  • Recognizes work-related problems and contributes to solutions.
  • Meets specific deadlines (responds to various workloads by assigning task priorities according to department policies, standards and needs).
  • Works with outside vendors to provide appropriate care needs for members
  • Maintains confidentiality of information between and among health care professionals.
  • Other duties as assigned by CM Manager or Director of Case Management.
  • Communication with multidisciplinary teams
  • Covering for other team members when needed (i.e. PTO, sick time)

Supervisory responsibilities:

N/A 

Minimum Requirements:

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. 

  1. Minimum Experience:
    1. Minimum 1 year front office medical assistant, related experience, and/or training; or equivalent combination of education and experience.
    2. Experience entering referrals and prior authorizations (highly preferred)
  2. Education/Licensure:
    1. High school diploma or general education degree (GED)
    2. Medical Terminology Certificate preferred
  3. Other:
    1. Knowledge of medical terminology
    2. Knowledge of ICD9 and CPT codes
    3. Knowledge of Managed Care Plans
    4. Computer proficient
    5. Able to type minimum 40 words per minute (WPM)
    6. Proficient in Microsoft Office (Outlook, Excel, Word)
    7. Bilingual English and either Spanish or Vietnamese required.
    8. Knowledge working in Access Express/Portal, Epic, Essette (not required)
    9. Good written, verbal, and telephonic communication skills
    10. 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.
    11. 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.
    12. 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.
    13. Good organizational skills
    14. Able to reason and carry out instructions.
    15. Good interpersonal skills.
    16. Read, write, and speak English fluently.
    17. File systematically.

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.

  1. 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.
  2. 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.

City: Remote-US

State: California

Location City: Remote-US

Location State: California

Community / Marketing Title: Care Coordinator, Chronic Kidney Disease (CKD)

Company Profile:

Alignment Health was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Health team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. 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 community.

EEO Employer Verbiage:

Alignment requires all new hires to follow local and/or state requirements regarding the COVID-19 vaccine and booster.  If applicable, proof of vaccination and booster will be required as a condition of employment subject to legal exemptions.  This policy, which Alignment reserves the right to modify, is part of Alignment’s ongoing efforts to ensure the safety and well-being of its staff and community and to support public health efforts.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].