Telephonic Care Coordinator, Bilingual Spanish

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

📋 Description

• Perform high-volume outbound telephonic outreach to members after their discharge from Hospitals and Skilled Nursing Facilities (SNFs).

• Adhere to established, time-sensitive outreach protocols while completing necessary outreach attempts and follow-up activities.

• Support members in scheduling prompt follow-up appointments with Care Anywhere providers and other healthcare resources.

• Utilize approved scripts and questionnaires to conduct outreach and gather necessary information.

• Ensure timely and accurate documentation across required systems.

• Create cases and tasks, and document activities within the Case Management module for Hospital and SNF discharges.

• Assist with referrals, authorizations, home health care (HHC), durable medical equipment (DME) needs, medication refills, provider appointments, follow-ups, and other care coordination requirements.

• Request and upload medical records from Hospitals, SNFs, primary care providers (PCPs), Specialists, and other healthcare entities.

• Complete tasks assigned by nursing staff and document as necessary.

• Collaborate with clinical and care management teams to engage and manage assigned members effectively.

• Monitor new alerts and escalate changes in condition, admissions, discharges, new diagnoses, or other clinical issues.

• Build relationships with members, gain their trust, and act as a patient advocate.

• Support outreach initiatives and provide cross-coverage for other member requirements.

• Maintain and update member records accordingly.

• Send or fax correspondence to both members and healthcare providers.

• Meet deadlines and prioritize workload in alignment with department policies, standards, and member needs.

• Uphold confidentiality of information.

⛳️ Requirements

• At least 1 year of experience in the healthcare sector, such as in a Health Plan, medical office, Independent Practice Association (IPA), or Managed Service Organization (MSO).

• Experience in conducting frequent or high-volume telephonic outreach to patients or members.

• Proven experience interacting directly with patients or members and assisting with healthcare-related scheduling, outreach, or front-office functions.

• High School Diploma or GED is required.

• Completion of an accredited Medical Assistant program is necessary.

• Willingness and ability to spend the majority of the workday on outbound telephonic member outreach.

• Consistently capable of performing time-sensitive outreach while adhering to established outreach and documentation protocols.

• Skilled at engaging members in a professional and empathetic manner over the phone while collecting information, completing questionnaires, and coordinating appropriate follow-ups.

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.

• Proficient in writing routine reports and correspondence.

• Communicates effectively with strong customer relations skills.

• Capable of communicating positively, professionally, and effectively with others; able to lead, teach, and collaborate with teammates.

• Strong problem-solving, organizational, and time management skills; ability to thrive in a fast-paced environment.

• Knowledge of Managed Care Plans.

• Familiarity with Medi-Cal.

• Proficient computer skills, typing at 35 WPM (Microsoft Outlook, Excel, Word).

• Ability to perform basic mathematical calculations.

• Ability to apply common sense understanding to execute detailed but straightforward written or oral instructions.

• Bilingual in English and Spanish.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment with a focus on teamwork.