Alignment Health

Bilingual

• Conduct outreach to members to support referrals, authorizations, medication refills, provider appointments, and other care needs
• Complete tasks and assessments in the Case Management system for hospital and SNF discharges
• Collaborate with RN Case Managers to manage a panel of SNP members
• Monitor alerts for changes in condition, admissions, discharges, and diagnoses, and communicate updates
• Build trust with members, acting as a liaison and advocate for their care
• Document interactions and maintain accurate member records
• Support communication with providers, including faxing/mailing of documents and requesting medical records
• Attend interdisciplinary team meetings and participate in member case reviews
• Maintain confidentiality and meet all departmental deadlines

Care Coordinator, SNP, Bilingual Vietnamese or Spanish

• Conduct outreach to members to support referrals, authorizations, medication refills, provider appointments, and other care needs.
• Complete tasks and assessments in the Case Management system for hospital and SNF discharges.
• Collaborate with RN Case Managers to manage a panel of SNP members.
• Monitor alerts for changes in condition, admissions, discharges, and diagnoses, and communicate updates.
• Build trust with members, acting as a liaison and advocate for their care.
• Document interactions and maintain accurate member records.
• Support communication with providers, including faxing/mailing of documents and requesting medical records.
• Attend interdisciplinary team meetings and participate in member case reviews.
• Maintain confidentiality and meet all departmental deadlines.

Care Coordinator, SNP

Financial Planning and Analysis

• Supervise, review, and participate in development and implementation of annual financial plan (budget), forecast, multi-year financial plan and analysis of major projects
• Develop Annual Financial Plan (Budget) as well as long term financial plans
• Analyze various strategic projects and incorporate into the financial plan
• Provide monthly / quarterly analyses on various issues, e.g. cash flow analysis, capital spending performance
• Develops and evaluates financial analyses and builds models to support new market/strategic investment opportunities
• Prepare various financial reports of programs for executive and board review
• Coordinate with Operators and Performance Optimization teams to ensure clear representation of financial outcomes relating to operational OKRs and KPIs
• Optimize reporting and analytics by leveraging ERP and Financial Planning systems
• Advanced financial modeling and scenario planning integrating operational drivers with financial information
• Develop financial projections using driver-based forecasting and rolling forecast methodologies
• Partner with operations leaders to quantify financial impact of performance improvement initiatives
• Perform related duties similar to the above in scope and function as required

Director, FP&A

Sales

• Meets and exceeds monthly goal and retention of existing members.
• Handles inside/in-bound telephone inquiries from prospective members, providers, and other community partners seeking information regarding all lines of business
• Directs prospects to the field sales team when needed
• Conducts outbound calls relevant to enrollment/disenrollment campaigns, requests for information from community events, provider offices, after-hour messages, and website inquiries
• Submits daily activity production reports and/or monthly reports as required.
• Ensures that information and assistance provided is within the standards established by all applicable federal /state laws and regulations and Alignment Health Plan’s Compliance Department
• Understands of new updates related to company and/or CMS and marketing guidelines required.
• Participates with competitor analysis (SWOTs) Strength, Weakness, Opportunities and Threats within respective market(s) and/or territories as required by management.
• Supports other projects within the Sales and Marketing Department as directed by the Management Team.
• Other duties may be assigned.

Telesales Retention Representative

Manager

• Work cross-organizationally and directly with clinical teams to translate business user requirements into systems support
• Support enhancements to existing systems and new system design, testing, documentation of workflows, and end user training
• Support Clinical Operations with new program projects that improve efficiencies across clinical teams
• Review and approve requirements, design specs, solution designs, functional requirements, prototypes, and system testing
• Document issues/resolutions, write requirements for system changes, create test scenarios and testing data
• Partner with AVA product development to create/execute training plans and customer-facing guides
• Review workflows, SOPs, policies and recommend changes to ensure efficient outputs
• Collaborate with leadership to create programs and ensure systems meet company and CMS requirements
• Build and update reports for performance management and compliance monitoring
• Adhere to Confidentiality and HIPAA regulations
• Other projects and duties as assigned

Alignment Health

Care Coordinator, SNP, Bilingual Vietnamese or Spanish

Care Coordinator, SNP

Director, FP&A

Telesales Retention Representative

Senior Manager, Clinical Systems and Special Projects

Principal Project Manager, DTS Process