Care Coordinator, SNP – Bilingual Spanish Preferred

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

📋 Description

• Contact members via telephone to provide assistance with referrals, authorizations, HHC, DME requirements, medication refills, provider appointments, and follow-up care.

• Generate cases and tasks and conduct assessments within the Case Management module for Hospital and SNF discharges.

• Complete tasks assigned by the nurse and document them appropriately.

• Collaborate with the Case Manager to engage and oversee a panel of SNP members.

• Monitor new alerts and inform the Case Manager of any changes in condition, admissions, discharges, or new diagnoses.

• Build rapport with members, gain their trust, and serve as a patient advocate.

• Raise concerns to the nurse if members demonstrate non-compliance or exhibit changes in their condition.

• Support outreach activities for members across all tiers of Case Management Programs.

• Keep member records up-to-date and accurate.

• Send or fax correspondence to members, PCPs, and/or specialists.

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

• Attend Interdisciplinary Team Meetings and contribute to member presentations when appropriate.

• Adhere to specific deadlines and prioritize tasks in accordance with department policies, standards, and requirements.

• Safeguard the confidentiality of information among healthcare professionals.

• Carry out other responsibilities as assigned by the CM Supervisor, Manager, or Director of Care Management.

⛳️ Requirements

• At least 1 year of experience working in Health Care IPAs.

• Minimum 1 year of experience with entering referrals and prior authorizations.

• High School Diploma or GED is required.

• A Bachelor's degree or four years of relevant experience may substitute for educational requirements.

• Capability to read and interpret safety regulations, operating and maintenance instructions, and procedural manuals.

• Ability to compose routine reports and correspondence.

• Strong communication and customer relations skills.

• Capacity to communicate positively, professionally, and effectively; provide leadership, teach, and collaborate.

• Proficient problem-solving, organizational, and time management skills.

• Ability to thrive in a fast-paced environment.

• Familiarity with Managed Care Plans.

• Knowledge of Medi-Cal.

• Basic computer skills with a typing speed of 25 WPM.

• Proficiency in Microsoft Outlook, Excel, and Word.

• Ability to perform basic arithmetic operations using American money, weight, volume, and distance measurements.

• Capability to apply common sense to detailed written or verbal instructions.

• Ability to address issues involving a few concrete variables in standardized scenarios.

• Bilingual in Spanish or Vietnamese is preferred.

• Training in Medical Assisting and Medical Terminology is preferred.

• Possession of a Medical Assistant Certificate and Medical Terminology Certificate is preferred.

• No licensure is required.

• Ability to fulfill the specified physical functions, including talking, hearing, standing, walking, sitting, handling objects, reaching, and frequently lifting or moving up to 10 pounds.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment fostering teamwork and collaboration.