Bilingual Care Coordinator, Outpatient Case Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Contact members via phone to provide assistance with referrals, authorizations, home health care (HHC), durable medical equipment (DME) needs, medication refills, scheduling provider appointments, and follow-ups, among other tasks.

• Generate cases, assign tasks, and finalize documentation within the case management module for all hospital and skilled nursing facility (SNF) discharges.

• Adhere to and document tasks assigned by the nursing staff.

• Collaborate as part of a team in this fully remote position with the case manager to engage and oversee a group of members.

• Monitor new alerts and inform the case manager about any changes in a member's condition, admissions, discharges, or new diagnoses.

• Build relationships with members to earn their trust and serve as their advocate.

• Raise concerns with the nurse if members seem non-compliant or if there are noticeable changes in their condition.

• Support outreach initiatives for members at all levels of case management programs.

• Help maintain and update records for members.

• Assist in mailing or faxing communications to members, primary care physicians (PCP), and/or specialists.

• Request and upload medical records from PCPs, specialists, hospitals, and other sources.

• Meet specific deadlines by prioritizing tasks based on departmental policies, standards, and requirements.

• Uphold the confidentiality of information shared among healthcare professionals.

• Carry out additional responsibilities as assigned by the case manager (CM) supervisor, manager, or director of care management.

⛳️ Requirements

• At least one (1) year of experience in healthcare settings such as health plans, medical offices, Independent Practice Associations (IPA), or Management Services Organizations.

• At least one (1) year of experience assisting members/patients with authorizations, appointment scheduling, resource identification, and related tasks.

• High School Diploma or GED is required.

• A Bachelor's degree or four years of additional experience in place of education is preferred.

• Training as a medical assistant or in medical terminology is preferred.

• Ability to read and comprehend documents such as safety guidelines, operation and maintenance instructions, and procedural manuals.

• Competent in writing routine reports and correspondence.

• Must exhibit strong problem-solving, organizational, and time management skills, and be capable of thriving in a fast-paced environment.

• Familiarity with Managed Care Plans.

• Knowledge of Medi-Cal.

• Basic computer skills with a typing speed of at least 35 words per minute (WPM).

• Proficient in the Microsoft Office suite (Outlook, Excel, Word).

• Bilingual in English and Spanish is preferred.

🏝️ Benefits

• Health insurance.

• Paid time off.

• Professional development opportunities.