Care Coordinator, Transition of Care, Bilingual Spanish

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, durable medical equipment needs, medication refills, provider appointments, and follow-ups.

• Create cases and tasks, and document them in the Case Management module for discharges from hospitals and skilled nursing facilities.

• Complete and document tasks assigned by the nursing staff.

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

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

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

• Escalate issues to the nurse if members appear non-compliant or demonstrate a change in condition.

• Support outreach activities for members within Case Management Programs.

• Maintain and update member records.

• Send or fax correspondence to members, primary care physicians, and specialists.

• Request and upload medical records from primary care physicians, specialists, hospitals, and other sources.

• Adhere to deadlines and prioritize tasks based on departmental policies, standards, and requirements.

• Ensure confidentiality of information among healthcare professionals.

• Perform additional duties as assigned by the Care Management Supervisor, Manager, or Director.

⛳️ Requirements

• At least 1 year of experience in a healthcare setting, such as a health plan, medical office, IPA, or MSO.

• A minimum of 1 year of experience in assisting members or patients with authorizations, appointment scheduling, resource identification, and similar needs.

• High school diploma or GED is required.

• A Bachelor's degree or four additional years of experience may be accepted in place of formal education.

• Ability to read and interpret safety guidelines, operating and maintenance instructions, and procedural manuals.

• Capable of writing routine reports and correspondence.

• Strong customer relations and professional communication skills.

• Ability to lead, teach, and collaborate effectively with others.

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

• Capacity to work in a fast-paced environment.

• Knowledge of managed care plans.

• Understanding 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 understanding to detailed written or oral instructions.

• Ability to address problems involving a limited number of concrete variables in standardized situations.

• Bilingual in English/Spanish is preferred.

• Medical Assistant training and Medical Terminology training are preferred.

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

• Ability to fulfill specified physical demands, including standing, walking, sitting, reaching, handling objects, and lifting or moving up to 10 pounds.

🏝️ Benefits

• [Details about benefits could be added here]