Care Coordinator, Chronic Kidney Disease

Alignment Healthcare

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

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.

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